RICHARD T MOON Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****23

License Status

ACTIVE

Business

First Name

RICHARD T

Last Name

MOON

Business Name

RICHARD T MOON

Original Issue Date

08/02/1982

Effective Date

09/23/2024

Expiration Date

09/30/2027

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/23/2024