MARCIE WAGNER-TIDABACK - Dentist License in Arizona | # 020008425

MARCIE WAGNER-TIDABACK

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020008425

License Status

NOT RENEWED

Business

N

First Name

MARCIE

Last Name

WAGNER-TIDABACK

Business Name

MARCIE WAGNER-TIDABACK

Original Issue Date

01/24/1995

Effective Date

01/24/1995

Expiration Date

09/30/2002

State

AZ

Ever Disciplined

N

LastModifiedDate

10/17/2005