CAROLYN R HETRICK DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001902

License Status

NOT RENEWED

Business

First Name

CAROLYN

Middle

Last Name

HETRICK

Suffix

DDS

Business Name

CAROLYN R HETRICK DDS

Original Issue Date

10/22/2013

Effective Date

01/31/2014

Expiration Date

06/30/2015

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

Advanced General Dentistry

Ever Disciplined

LastModifiedDate

01/07/2016