MATT G VANDERMOLEN DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000652

License Status

ACTIVE

Business

First Name

MATT

Middle

Last Name

VANDERMOLEN

Suffix

DDS

Business Name

MATT G VANDERMOLEN DDS

Original Issue Date

05/26/2005

Effective Date

07/10/2024

Expiration Date

09/30/2027

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

LastModifiedDate

07/10/2024