TRISTA EILEEN POTTENGER DMD - Dentist License in Illinois | # 019030151

TRISTA EILEEN POTTENGER DMD

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019030151

License Status

NOT RENEWED

Business

N

Title

DMD

First Name

TRISTA

Middle

EILEEN

Last Name

POTTENGER

Business Name

TRISTA EILEEN POTTENGER DMD

Original Issue Date

05/11/2015

Effective Date

09/16/2015

Expiration Date

09/30/2018

State

IL

Ever Disciplined

N

LastModifiedDate

10/31/2018