BEAU GARRET MOODY DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019028093

License Status

ACTIVE

Business

First Name

BEAU

Middle

GARRET

Last Name

MOODY

Suffix

DMD

Business Name

BEAU GARRET MOODY DMD

Original Issue Date

07/21/2009

Effective Date

07/29/2024

Expiration Date

09/30/2027

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

07/29/2024