TRISTA EILEEN POTTENGER DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019030151

License Status

NOT RENEWED

Business

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

City

OTTAWA

State

Zip

61350

County

LA SALLE

Ever Disciplined

LastModifiedDate

10/31/2018