STACEY L MACK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020008577

License Status

NOT RENEWED

Business

First Name

STACEY L

Last Name

MACK

Business Name

STACEY L MACK

Original Issue Date

08/09/1995

Effective Date

08/09/1995

Expiration Date

09/30/2002

City

BETTENDORF

State

Zip

52722

County

IOWA

Ever Disciplined

LastModifiedDate

10/17/2005