DOMINIQUE ELENA DIETRICH - Dentist License in Illinois | # 020015259

DOMINIQUE ELENA DIETRICH

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020015259

License Status

NOT RENEWED

Business

N

First Name

DOMINIQUE

Middle

ELENA

Last Name

DIETRICH

Business Name

DOMINIQUE ELENA DIETRICH

Original Issue Date

08/07/2015

Effective Date

09/25/2018

Expiration Date

01/31/2022

State

IL

Ever Disciplined

N

LastModifiedDate

05/09/2022