MICHELE M FORTIN - Dentist License in Illinois | # 020002747

MICHELE M FORTIN

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020002747

License Status

NOT RENEWED

Business

N

First Name

MICHELE M

Last Name

FORTIN

Business Name

MICHELE M FORTIN

Original Issue Date

12/03/1975

Effective Date

12/03/1975

Expiration Date

04/01/1982

State

IL

Ever Disciplined

N

LastModifiedDate

10/12/2005