SANDRA F DERHAKE Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020002694

License Status

INACTIVE

Business

First Name

SANDRA F

Last Name

DERHAKE

Business Name

SANDRA F DERHAKE

Original Issue Date

08/27/1975

Effective Date

08/27/1975

Expiration Date

09/30/2004

City

LIBERTY

State

Zip

62347

County

ADAMS

Ever Disciplined

LastModifiedDate

10/17/2005