STACY R MOODY DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019026581

License Status

ACTIVE

Business

First Name

STACY

Middle

Last Name

MOODY

Suffix

DMD

Business Name

STACY R MOODY DMD

Original Issue Date

09/09/2004

Effective Date

08/30/2024

Expiration Date

09/30/2027

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

08/30/2024