TIMOTHY DAVID THEOBALD DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019030011

License Status

ACTIVE

Business

Title

DMD

First Name

TIMOTHY

Middle

DAVID

Last Name

THEOBALD

Business Name

TIMOTHY DAVID THEOBALD DMD

Original Issue Date

08/06/2014

Effective Date

09/25/2024

Expiration Date

09/30/2027

City

HAINESVILLE

State

Zip

60030

County

LAKE

Ever Disciplined

LastModifiedDate

09/25/2024