MICHELLE LEE BROUILLETTE - Dentist License in Wisconsin | # 020010638

MICHELLE LEE BROUILLETTE

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020010638

License Status

INACTIVE

Business

N

First Name

MICHELLE

Middle

LEE

Last Name

BROUILLETTE

Business Name

MICHELLE LEE BROUILLETTE

Original Issue Date

06/25/2003

Effective Date

10/01/2006

Expiration Date

09/30/2009

State

WI

Ever Disciplined

N

LastModifiedDate

06/04/2009