TIMOTHY T MOSS DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****20

License Status

NOT RENEWED

Business

First Name

TIMOTHY

Middle

Last Name

MOSS

Suffix

DDS

Business Name

TIMOTHY T MOSS DDS

Original Issue Date

07/28/2005

Effective Date

06/04/2009

Expiration Date

09/30/2012

City

BOLINGBROOK

State

Zip

60440

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012