License holder summary

Lakewood Oral & Maxillofacial Surgery Specialist is a Dental - Deep Sedation/General Anesthesia Site Certificate licensed to practice in Missouri. The address on file for Lakewood Oral & Maxillofacial Surgery Specialist is 3600 NE Ralph Powell Rd , Lees Summit 64064. This licensed professional license is current. The license was granted 08/20/2012 and expired on 06/01/2017.

Missouri

Division of Professional Registration

Lakewood Oral & Maxillofacial Surgery Specialist
Dental - Deep Sedation/General Anesthesia Site Certificate
License number
2012029208  
Date granted
08/20/2012
Date expires
06/01/2017
Class
Dental - Deep Sedation/General Anesthesia Site Certificate
Status
Clear
Address
3600 NE Ralph Powell Rd 
licensingmissouri.org
ID 2043354
LAST UPDATED 2026-06-28 19:48:42 UTC

This website is unaffiliated with the Division of Professional Registration. Please verify all information directly with the relevant official government authority.

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