GRACE BRONIECKI BLOOMSTRAND Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020000720

License Status

NOT RENEWED

Business

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

City

GLEN ELLYN

State

Zip

60137

County

DUPAGE

Ever Disciplined

LastModifiedDate

11/08/2006