Missouri
Division of Professional Registration
Personal Care Dental Group
Dental - Deep Sedation/General Anesthesia Site Certificate
License number
2011041699
Date granted
12/30/2011
Date expires
06/01/2016
Class
Dental - Deep Sedation/General Anesthesia Site Certificate
Status
Clear
Address
9500 E 63rd St
licensingmissouri.org
ID 2043542
LAST UPDATED 2026-05-07 15:30:38 UTC
LAST UPDATED 2026-05-07 15:30:38 UTC
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