SHELLEY VALERIA WIEGAND Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020002838

License Status

NOT RENEWED

Business

First Name

SHELLEY VALERIA

Last Name

WIEGAND

Business Name

SHELLEY VALERIA WIEGAND

Original Issue Date

07/13/1976

Effective Date

07/13/1976

Expiration Date

09/30/2002

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/17/2005