NICHOLAS THEODORE MOORE Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020016606

License Status

ACTIVE

Business

First Name

NICHOLAS

Middle

THEODORE

Last Name

MOORE

Business Name

NICHOLAS THEODORE MOORE

Original Issue Date

07/30/2019

Effective Date

05/02/2024

Expiration Date

09/30/2027

City

PEORIA

State

Zip

61604

County

PEORIA

Ever Disciplined

LastModifiedDate

05/02/2024