ROBERT CARL MOEN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****46

License Status

NOT RENEWED

Business

First Name

ROBERT CARL

Last Name

MOEN

Business Name

ROBERT CARL MOEN

Original Issue Date

11/25/1985

Effective Date

08/10/2018

Expiration Date

01/31/2022

City

PARK RIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022