THOMAS RICHARD MATTESON DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019013642

License Status

INACTIVE

Business

First Name

THOMAS

Middle

RICHARD

Last Name

MATTESON

Suffix

DDS

Business Name

THOMAS RICHARD MATTESON DDS

Original Issue Date

07/14/1969

Effective Date

06/30/2009

Expiration Date

09/30/2012

City

ALBUQUERQUE

State

Zip

87112

County

NEW MEXICO

Ever Disciplined

LastModifiedDate

06/06/2012