TRACEY LYNN CLARK - Dentist License in Indiana | # 020009614

TRACEY LYNN CLARK

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020009614

License Status

NOT RENEWED

Business

N

First Name

TRACEY

Middle

LYNN

Last Name

CLARK

Business Name

TRACEY LYNN CLARK

Original Issue Date

08/27/1999

Effective Date

08/27/1999

Expiration Date

09/30/2002

State

IN

Ever Disciplined

N

LastModifiedDate

10/17/2005