THERESE SUZANNE BERGSTROM Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020005016

License Status

INACTIVE

Business

First Name

THERESE

Middle

SUZANNE

Last Name

BERGSTROM

Business Name

THERESE SUZANNE BERGSTROM

Original Issue Date

08/20/1982

Effective Date

03/23/2011

Expiration Date

09/30/2012

City

LA MESA

State

Zip

91941

County

CALIFORNIA

Ever Disciplined

LastModifiedDate

03/17/2011