GRACE BRONIECKI BLOOMSTRAND - Dentist License in Illinois | # 020000720

GRACE BRONIECKI BLOOMSTRAND

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020000720

License Status

NOT RENEWED

Business

N

First Name

GRACE BRONIECKI

Last Name

BLOOMSTRAND

Business Name

GRACE BRONIECKI BLOOMSTRAND

Original Issue Date

07/14/1964

Effective Date

09/30/2004

Expiration Date

09/30/2006

State

IL

Ever Disciplined

N

LastModifiedDate

11/08/2006