ELIZABETH A GALLIVAN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020003109

License Status

NOT RENEWED

Business

First Name

ELIZABETH A

Last Name

GALLIVAN

Business Name

ELIZABETH A GALLIVAN

Original Issue Date

06/09/1977

Effective Date

06/09/1977

Expiration Date

04/01/1982

City

FORT COLLINS

State

Zip

80525

County

COLORADO

Ever Disciplined

LastModifiedDate

10/12/2005