STACEY M BAENEN Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020007624

License Status

INACTIVE

Business

First Name

STACEY M

Last Name

BAENEN

Business Name

STACEY M BAENEN

Original Issue Date

02/24/1992

Effective Date

10/01/2006

Expiration Date

09/30/2009

City

SAN FRANCISCO

State

Zip

94118

County

CALIFORNIA

Ever Disciplined

LastModifiedDate

06/04/2009