ANDY J MALCOLM DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000703

License Status

ACTIVE

Business

First Name

ANDY

Middle

Last Name

MALCOLM

Suffix

DDS

Business Name

ANDY J MALCOLM DDS

Original Issue Date

08/08/2007

Effective Date

05/06/2024

Expiration Date

09/30/2027

City

BELVIDERE

State

Zip

61008

County

BOONE

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

LastModifiedDate

05/06/2024