NICHOLAS ANTONEE MOSLEY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****37

License Status

NOT RENEWED

Business

First Name

NICHOLAS ANTONEE

Last Name

MOSLEY

Business Name

NICHOLAS ANTONEE MOSLEY

Original Issue Date

11/16/1984

Effective Date

11/16/1984

Expiration Date

09/30/1988

City

EAST ST LOUIS

State

Zip

62204

County

SAINT CLAIR

Controlled Substance Schedule

II IV

Ever Disciplined

LastModifiedDate

08/03/2018