ANDREA G MOSLEY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020009037

License Status

NOT RENEWED

Business

First Name

ANDREA G

Last Name

MOSLEY

Business Name

ANDREA G MOSLEY

Original Issue Date

07/29/1997

Effective Date

10/01/2015

Expiration Date

09/30/2018

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

10/31/2018

Case Number

2017011134

Action

Suspension

Discipline Start Date

02/02/2018

Discipline End Date

06/06/2018

Discipline Reason

Failure to file and/or pay Illinois state income taxes. Notice of tax deficiency release received from Department of Revenue on 06/07/2018.