RHONDA NICOLE GREEN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001002

License Status

NOT RENEWED

Business

First Name

RHONDA NICOLE

Last Name

GREEN

Suffix

DMD

Business Name

RHONDA NICOLE GREEN DMD

Original Issue Date

12/04/1996

Effective Date

12/04/1996

Expiration Date

06/30/1998

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005