MICHAEL J FADDIS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

RESTRICTED FACULTY LICENSE

License Number

136000276

License Status

ACTIVE

Business

First Name

MICHAEL

Middle

Last Name

FADDIS

Business Name

MICHAEL J FADDIS

Original Issue Date

02/06/2024

Effective Date

09/06/2024

Expiration Date

09/30/2027

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

11/07/2024