JILL LAVERN MANVILLA - Dentist License in Indiana | # 020002814

JILL LAVERN MANVILLA

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020002814

License Status

NOT RENEWED

Business

N

First Name

JILL LAVERN

Last Name

MANVILLA

Business Name

JILL LAVERN MANVILLA

Original Issue Date

07/13/1976

Effective Date

07/13/1976

Expiration Date

09/30/1984

State

IN

Ever Disciplined

N

LastModifiedDate

10/12/2005