MICHAEL C MOON DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****99

License Status

ACTIVE

Business

First Name

MICHAEL C

Last Name

MOON

Suffix

DDS

Business Name

MICHAEL C MOON DDS

Original Issue Date

03/06/1995

Effective Date

06/17/2024

Expiration Date

09/30/2027

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/17/2024