MATT ADAM MLSNA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019019732

License Status

NOT RENEWED

Business

First Name

MATT ADAM

Last Name

MLSNA

Business Name

MATT ADAM MLSNA

Original Issue Date

08/07/1985

Effective Date

09/28/2021

Expiration Date

09/30/2024

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

02/04/2025