MICHAEL DAVID DEGOULD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021001500

License Status

ACTIVE

Business

First Name

MICHAEL DAVID

Last Name

DEGOULD

Business Name

MICHAEL DAVID DEGOULD

Original Issue Date

10/02/1990

Effective Date

05/02/2024

Expiration Date

09/30/2027

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

Oral and Maxillofacial Surgery

Ever Disciplined

LastModifiedDate

05/02/2024