ROBIN MONTGOMERY HATHORN - Dentist License in Illinois | # 018001167

ROBIN MONTGOMERY HATHORN

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001167

License Status

NOT RENEWED

Business

N

First Name

ROBIN

Middle

MONTGOMERY

Last Name

HATHORN

Business Name

ROBIN MONTGOMERY HATHORN

Original Issue Date

06/15/1999

Effective Date

06/15/1999

Expiration Date

06/30/2001

State

IL

Specialty/Qualifier

General Practice Residency

Ever Disciplined

N

LastModifiedDate

10/12/2005