BRENDEN D MOON DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****41

License Status

ACTIVE

Business

First Name

BRENDEN

Middle

Last Name

MOON

Suffix

DMD

Business Name

BRENDEN D MOON DMD

Original Issue Date

05/01/2012

Effective Date

09/06/2024

Expiration Date

09/30/2027

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/06/2024