MARY ELLEN HEAD Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020001786

License Status

INACTIVE

Business

First Name

MARY ELLEN

Last Name

HEAD

Business Name

MARY ELLEN HEAD

Original Issue Date

07/13/1972

Effective Date

09/30/2004

Expiration Date

09/30/2006

City

OREGON

State

Zip

61061

County

OGLE

Ever Disciplined

LastModifiedDate

07/24/2006