MITZY ANN GOLDEN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****50

License Status

NOT RENEWED

Business

Title

DDS

First Name

MITZY

Middle

ANN

Last Name

GOLDEN

Business Name

MITZY ANN GOLDEN DDS

Original Issue Date

08/05/2014

Effective Date

08/05/2014

Expiration Date

09/30/2015

City

MATTOON

State

Zip

61938

County

COLES

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016