STACY LOUISE BERGSMITH - Dentist License in Georgia | # 020005993

STACY LOUISE BERGSMITH

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020005993

License Status

INACTIVE

Business

N

First Name

STACY LOUISE

Last Name

BERGSMITH

Business Name

STACY LOUISE BERGSMITH

Original Issue Date

09/17/1985

Effective Date

09/30/2004

Expiration Date

09/30/2006

State

GA

Ever Disciplined

N

LastModifiedDate

07/24/2006