KELLI J MOON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020010780

License Status

NOT RENEWED

Business

First Name

KELLI

Middle

Last Name

MOON

Business Name

KELLI J MOON

Original Issue Date

08/27/2003

Effective Date

10/02/2018

Expiration Date

01/31/2022

City

EFFINGHAM

State

Zip

62401

County

SHELBY

Ever Disciplined

LastModifiedDate

05/09/2022