TANNER MOORE FLAHERTY DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000953

License Status

ACTIVE

Business

Title

DMD

First Name

TANNER

Middle

MOORE

Last Name

FLAHERTY

Business Name

TANNER MOORE FLAHERTY DMD

Original Issue Date

06/09/2016

Effective Date

08/19/2024

Expiration Date

09/30/2027

City

SPRINGFIELD

State

Zip

62712

County

SANGAMON

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

LastModifiedDate

08/19/2024