CORISSA ANN FORTINI Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020010730

License Status

NOT RENEWED

Business

First Name

CORISSA

Middle

ANN

Last Name

FORTINI

Business Name

CORISSA ANN FORTINI

Original Issue Date

07/24/2003

Effective Date

09/29/2021

Expiration Date

09/30/2024

City

BENTONVILLE

State

Zip

72713

Ever Disciplined

LastModifiedDate

02/04/2025