JACYN DALE STULTZ Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020003687

License Status

NOT RENEWED

Business

First Name

JACYN DALE

Last Name

STULTZ

Business Name

JACYN DALE STULTZ

Original Issue Date

09/11/1978

Effective Date

09/11/1978

Expiration Date

09/30/1984

City

AMBOY

State

Zip

61310

County

LEE

Ever Disciplined

LastModifiedDate

10/12/2005