MARA K GANIM DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021002984

License Status

ACTIVE

Business

Title

DMD

First Name

MARA

Middle

Last Name

GANIM

Business Name

MARA K GANIM DMD

Original Issue Date

09/09/2019

Effective Date

09/03/2024

Expiration Date

09/30/2027

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Specialty/Qualifier

PEDIATRIC DENTIST

Ever Disciplined

LastModifiedDate

09/03/2024