KATHLEEN MARY SMITH Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020003544

License Status

NOT RENEWED

Business

First Name

KATHLEEN MARY

Last Name

SMITH

Business Name

KATHLEEN MARY SMITH

Original Issue Date

06/23/1978

Effective Date

09/18/2012

Expiration Date

09/30/2015

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

04/25/2016