LISA A BUSH Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019023120

License Status

NOT RENEWED

Business

First Name

LISA A

Last Name

BUSH

Business Name

LISA A BUSH

Original Issue Date

01/12/1993

Effective Date

09/30/2015

Expiration Date

09/30/2018

City

MARYVILLE

State

Zip

62062

County

MADISON

Ever Disciplined

LastModifiedDate

10/31/2018