AMBER THERESA MISIC Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020012584

License Status

INACTIVE

Business

First Name

AMBER

Middle

THERESA

Last Name

MISIC

Business Name

AMBER THERESA MISIC

Original Issue Date

07/03/2008

Effective Date

07/03/2008

Expiration Date

09/30/2009

City

LAFAYETTE

State

Zip

80026

Ever Disciplined

LastModifiedDate

06/04/2009