STACEY M BAENEN - Dentist License in California | # 020007624

STACEY M BAENEN

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020007624

License Status

INACTIVE

Business

N

First Name

STACEY M

Last Name

BAENEN

Business Name

STACEY M BAENEN

Original Issue Date

02/24/1992

Effective Date

10/01/2006

Expiration Date

09/30/2009

State

CA

Ever Disciplined

N

LastModifiedDate

06/04/2009