LISA M PETERSEN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020013444

License Status

NOT RENEWED

Business

First Name

LISA

Middle

Last Name

PETERSEN

Business Name

LISA M PETERSEN

Original Issue Date

12/02/2010

Effective Date

08/24/2015

Expiration Date

09/30/2018

City

GOOSE LAKE

State

Zip

52750

County

IOWA

Ever Disciplined

LastModifiedDate

10/31/2018