REGINA M MORT Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020003121

License Status

NOT RENEWED

Business

First Name

REGINA M

Last Name

MORT

Business Name

REGINA M MORT

Original Issue Date

06/09/1977

Effective Date

06/25/2012

Expiration Date

09/30/2015

City

PEOTONE

State

Zip

60468

County

WILL

Ever Disciplined

LastModifiedDate

04/25/2016