KATHRYN A BANTA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020002174

License Status

NOT RENEWED

Business

First Name

KATHRYN A

Last Name

BANTA

Business Name

KATHRYN A BANTA

Original Issue Date

07/03/1974

Effective Date

09/02/2015

Expiration Date

09/30/2018

City

DEKALB

State

Zip

60115

County

DEKALB

Ever Disciplined

LastModifiedDate

10/31/2018