BEVERLY ANN BLACK Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020001846

License Status

INACTIVE

Business

First Name

BEVERLY ANN

Last Name

BLACK

Business Name

BEVERLY ANN BLACK

Original Issue Date

07/12/1972

Effective Date

09/30/2004

Expiration Date

09/30/2006

City

STERLING

State

Zip

61081

County

WHITESIDE

Ever Disciplined

LastModifiedDate

07/24/2006