PATRICIA DIANE BOUMAN - Dentist License in Illinois | # 020004319

PATRICIA DIANE BOUMAN

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020004319

License Status

NOT RENEWED

Business

N

First Name

PATRICIA DIANE

Last Name

BOUMAN

Business Name

PATRICIA DIANE BOUMAN

Original Issue Date

08/15/1980

Effective Date

08/15/1980

Expiration Date

04/01/1982

State

IL

Ever Disciplined

N

LastModifiedDate

10/12/2005