THOMAS RICHARD MATTESON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****74

License Status

NOT RENEWED

Business

First Name

THOMAS

Middle

RICHARD

Last Name

MATTESON

Suffix

DDS

Business Name

THOMAS RICHARD MATTESON DDS

Original Issue Date

01/01/1998

Expiration Date

01/01/1998

City

STERLING

State

Zip

61081

County

WHITESIDE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005