SUSAN LYNN LARSON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020002207

License Status

NOT RENEWED

Business

First Name

SUSAN LYNN

Last Name

LARSON

Business Name

SUSAN LYNN LARSON

Original Issue Date

07/03/1974

Effective Date

09/17/2012

Expiration Date

09/30/2015

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

04/25/2016