MARY J SELGRAT Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020001920

License Status

INACTIVE

Business

First Name

MARY

Middle

Last Name

SELGRAT

Business Name

MARY J SELGRAT

Original Issue Date

07/11/1973

Effective Date

07/11/1973

Expiration Date

09/30/2000

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/17/2005