DIANE GARDINER MANIS - Dentist License in Illinois | # 020002491

DIANE GARDINER MANIS

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020002491

License Status

NOT RENEWED

Business

N

First Name

DIANE GARDINER

Last Name

MANIS

Business Name

DIANE GARDINER MANIS

Original Issue Date

07/10/1975

Effective Date

07/10/1975

Expiration Date

09/30/1998

State

IL

Ever Disciplined

N

LastModifiedDate

10/12/2005