RYAN T MOORE DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****35

License Status

ACTIVE

Business

First Name

RYAN

Middle

Last Name

MOORE

Suffix

DMD

Business Name

RYAN T MOORE DMD

Original Issue Date

04/20/2004

Effective Date

08/30/2024

Expiration Date

09/30/2027

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/30/2024