BRYAN M GOLDESBERRY Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****32

License Status

ACTIVE

Business

First Name

BRYAN

Middle

Last Name

GOLDESBERRY

Business Name

BRYAN M GOLDESBERRY

Original Issue Date

04/18/2012

Effective Date

09/13/2024

Expiration Date

09/30/2027

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/13/2024