GERALD RODGER MOON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****27

License Status

NOT RENEWED

Business

First Name

GERALD RODGER

Last Name

MOON

Suffix

DDS

Business Name

GERALD RODGER MOON DDS

Original Issue Date

01/01/1998

Effective Date

09/04/2009

Expiration Date

09/30/2012

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

I II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012