THOMAS HAROLD MOORE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****28

License Status

NOT RENEWED

Business

First Name

THOMAS HAROLD

Last Name

MOORE

Suffix

DDS

Business Name

THOMAS HAROLD MOORE DDS

Original Issue Date

01/01/1998

Effective Date

09/28/2009

Expiration Date

09/30/2012

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

III

Ever Disciplined

LastModifiedDate

11/14/2012