THOMAS RYAN MOSS DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****18

License Status

NOT RENEWED

Business

First Name

THOMAS

Middle

RYAN

Last Name

MOSS

Suffix

DDS

Business Name

THOMAS RYAN MOSS DDS

Original Issue Date

01/01/1998

Effective Date

09/29/2015

Expiration Date

09/30/2018

City

ROCKFORD

State

Zip

61112

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018