GERALDINE CUDDEBACK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020001682

License Status

NOT RENEWED

Business

First Name

GERALDINE

Last Name

CUDDEBACK

Business Name

GERALDINE CUDDEBACK

Original Issue Date

07/13/1972

Effective Date

07/13/1972

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/12/2005