SUSAN BOUCHARD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020001575

License Status

NOT RENEWED

Business

First Name

SUSAN

Last Name

BOUCHARD

Business Name

SUSAN BOUCHARD

Original Issue Date

07/08/1971

Effective Date

07/08/1971

Expiration Date

04/01/1982

City

SCOTTSDALE

State

Zip

85253

County

ARIZONA

Ever Disciplined

LastModifiedDate

10/12/2005