TSBDE Dentist: GOODWIN, MICHAEL DAVID # 23642

License Number 23642
License Status Revoked
License Issue Date 10/26/2007
License Expiration Date 10/31/2013
 
 
Last Name GOODWIN
Former Last Name GOODWIN
First Name MICHAEL
Middle Name DAVID
Gender Male
Address 3629 WOLFLIN AVE
 
City AMARILLO
State TX
Zip Code 79102
County POTTER
 
 
Nitrous Certification Date No Permit
Anesthesia Level 1 Permit Issue Date No Permit
Anesthesia Level 2 Permit Issue Date No Permit
Anesthesia Level 3 Permit Issue Date No Permit
Anesthesia Level 4 Permit Issue Date No Permit
 
 
Type of Practice ORTH
Year Graduated 1977
Dental School Indiana U
Year of Birth 1949
Disciplinary Action Yes
Disciplinary Action Portal

CERTIFICATION OF INFORMATION: The Texas State Board of Dental Examiners certifies that it maintains the information for the license verification functions of this website, performs daily updates to the website and considers the website to be a secure, primary source for license verification.

Codes for Type of Practice

DPH=Dental Public Health
END=Endodontics
GEN=General Dentistry
OMP=Oral&Maxilofacial Pathology
OMR=Oral&Maxilofacial Radiology
OMS=Oral&Maxilofacial Surgery
ORTH=Orthodontics
PEDO=Pediatric Dentistry
PERI=Periodontics
PROS=Prosthodontics