DIANE GARDINER MANIS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020002491

License Status

NOT RENEWED

Business

First Name

DIANE GARDINER

Last Name

MANIS

Business Name

DIANE GARDINER MANIS

Original Issue Date

07/10/1975

Effective Date

07/10/1975

Expiration Date

09/30/1998

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

10/12/2005