TARA MICHELE GRIFFIN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000554

License Status

NOT RENEWED

Business

First Name

TARA

Middle

MICHELE

Last Name

GRIFFIN

Suffix

DMD

Business Name

TARA MICHELE GRIFFIN DMD

Original Issue Date

04/25/2002

Effective Date

10/01/2009

Expiration Date

09/30/2012

City

DECATUR

State

Zip

62521

County

MACON

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

LastModifiedDate

11/14/2012