PHILIP R BANGHART DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000379

License Status

ACTIVE

Business

First Name

PHILIP R

Last Name

BANGHART

Suffix

DDS

Business Name

PHILIP R BANGHART DDS

Original Issue Date

07/24/1995

Effective Date

05/01/2024

Expiration Date

09/30/2027

City

MATTOON

State

Zip

61938

County

COLES

Specialty/Qualifier

Deep Sedation and General Anesthesia

Ever Disciplined

LastModifiedDate

05/01/2024