MILDRED KOUBA TRAVIS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020000011

License Status

NOT RENEWED

Business

First Name

MILDRED KOUBA

Last Name

TRAVIS

Business Name

MILDRED KOUBA TRAVIS

Original Issue Date

11/19/1946

Effective Date

11/19/1946

Expiration Date

09/30/1984

City

FREEPORT

State

Zip

61032

County

STEPHENSON

Ever Disciplined

LastModifiedDate

10/12/2005