TIFFANY ELISA ANDERSEN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019028462

License Status

NOT RENEWED

Business

First Name

TIFFANY

Middle

ELISA

Last Name

ANDERSEN

Business Name

TIFFANY ELISA ANDERSEN

Original Issue Date

08/06/2010

Effective Date

08/06/2010

Expiration Date

09/30/2012

City

GILBERT

State

Zip

85296

County

ARIZONA

Ever Disciplined

LastModifiedDate

11/14/2012