STACIE DIANE BEASLEY DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019028850

License Status

ACTIVE

Business

Title

DDS

First Name

STACIE

Middle

DIANE

Last Name

BEASLEY

Business Name

STACIE DIANE BEASLEY DDS

Original Issue Date

09/06/2011

Effective Date

09/27/2024

Expiration Date

09/30/2027

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/27/2024