GLORIA ANN KULLBERG Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020001778

License Status

NOT RENEWED

Business

First Name

GLORIA ANN

Last Name

KULLBERG

Business Name

GLORIA ANN KULLBERG

Original Issue Date

07/13/1972

Effective Date

07/13/1972

Expiration Date

09/30/2004

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/17/2005