KATHRYN RAE MOORE DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****17

License Status

ACTIVE

Business

First Name

KATHRYN

Middle

RAE

Last Name

MOORE

Suffix

DMD

Business Name

KATHRYN RAE MOORE DMD

Original Issue Date

07/15/2009

Effective Date

05/02/2024

Expiration Date

09/30/2027

City

COLLINSVILLE

State

Zip

62234

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/02/2024