STACY LOUISE BERGSMITH Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020005993

License Status

INACTIVE

Business

First Name

STACY LOUISE

Last Name

BERGSMITH

Business Name

STACY LOUISE BERGSMITH

Original Issue Date

09/17/1985

Effective Date

09/30/2004

Expiration Date

09/30/2006

City

RICHMOND HILL

State

Zip

31324

County

GEORGIA

Ever Disciplined

LastModifiedDate

07/24/2006