MARIJO BLANK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020001849

License Status

NOT RENEWED

Business

First Name

MARIJO

Last Name

BLANK

Business Name

MARIJO BLANK

Original Issue Date

07/12/1972

Effective Date

07/12/1972

City

WEST CHICAGO

State

Zip

60185

County

DUPAGE

Ever Disciplined

LastModifiedDate

10/12/2005