DANIEL J MOFFETT Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****36

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

Last Name

MOFFETT

Business Name

DANIEL J MOFFETT

Original Issue Date

02/16/1988

Effective Date

02/16/1988

Expiration Date

09/30/1988

City

ZION

State

Zip

60099

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005