NICOLE FAITH KOONTZ - Dentist License in Wisconsin | # 020014279

NICOLE FAITH KOONTZ

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020014279

License Status

INACTIVE

Business

N

First Name

NICOLE

Middle

FAITH

Last Name

KOONTZ

Business Name

NICOLE FAITH KOONTZ

Original Issue Date

05/23/2013

Effective Date

05/23/2013

Expiration Date

09/30/2015

State

WI

Ever Disciplined

N

LastModifiedDate

06/08/2015