BRENDEN D MOON DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****22

License Status

ACTIVE

Business

First Name

BRENDEN

Middle

Last Name

MOON

Suffix

DMD

Business Name

BRENDEN D MOON DMD

Original Issue Date

06/25/2007

Effective Date

09/06/2024

Expiration Date

09/30/2027

City

CARTHAGE

State

Zip

62321

County

HANCOCK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/06/2024