SUE ANN SHEPHERD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020003119

License Status

NOT RENEWED

Business

First Name

SUE ANN

Last Name

SHEPHERD

Business Name

SUE ANN SHEPHERD

Original Issue Date

06/09/1977

Effective Date

06/09/1977

Expiration Date

09/30/2004

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

10/17/2005