KYLE BLAKE HAGEN DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019024215

License Status

ACTIVE

Business

First Name

KYLE BLAKE

Last Name

HAGEN

Suffix

DMD

Business Name

KYLE BLAKE HAGEN DMD

Original Issue Date

08/01/1996

Effective Date

05/01/2024

Expiration Date

09/30/2027

City

EAST ALTON

State

Zip

62024

County

MADISON

Ever Disciplined

LastModifiedDate

05/01/2024