MITZY ANN GOLDEN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019030005

License Status

NOT RENEWED

Business

Title

DDS

First Name

MITZY

Middle

ANN

Last Name

GOLDEN

Business Name

MITZY ANN GOLDEN DDS

Original Issue Date

08/05/2014

Effective Date

08/05/2014

Expiration Date

09/30/2015

City

MATTOON

State

Zip

61938

County

COLES

Ever Disciplined

LastModifiedDate

02/08/2016