JUDITH BLOCK WAGNER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020000406

License Status

NOT RENEWED

Business

First Name

JUDITH BLOCK

Last Name

WAGNER

Business Name

JUDITH BLOCK WAGNER

Original Issue Date

01/01/1998

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/12/2005