THOMAS W FONNER DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000495

License Status

ACTIVE

Business

First Name

THOMAS

Middle

Last Name

FONNER

Suffix

DMD

Business Name

THOMAS W FONNER DMD

Original Issue Date

05/12/2000

Effective Date

06/03/2024

Expiration Date

09/30/2027

City

EFFINGHAM

State

Zip

62401

County

EFFINGHAM

Specialty/Qualifier

Deep Sedation and General Anesthesia

Ever Disciplined

LastModifiedDate

06/03/2024