DERRIK LANCE RICHARD DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019024830

License Status

ACTIVE

Business

First Name

DERRIK

Middle

LANCE

Last Name

RICHARD

Suffix

DMD

Business Name

DERRIK LANCE RICHARD DMD

Original Issue Date

09/04/1998

Effective Date

08/31/2024

Expiration Date

09/30/2027

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

08/31/2024