JEROME EUGENE SERVIE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020001873

License Status

NOT RENEWED

Business

First Name

JEROME EUGENE

Last Name

SERVIE

Business Name

JEROME EUGENE SERVIE

Original Issue Date

11/02/1972

Effective Date

06/10/2009

Expiration Date

09/30/2012

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Ever Disciplined

LastModifiedDate

11/14/2012