SUSAN MARY LARSON - Dentist License in Illinois | # 020003063

SUSAN MARY LARSON

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020003063

License Status

NOT RENEWED

Business

N

First Name

SUSAN MARY

Last Name

LARSON

Business Name

SUSAN MARY LARSON

Original Issue Date

02/22/1977

Effective Date

02/22/1977

State

IL

Ever Disciplined

N

LastModifiedDate

10/12/2005