JEANNINE CARLA DOUGHERTY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020003731

License Status

NOT RENEWED

Business

First Name

JEANNINE CARLA

Last Name

DOUGHERTY

Business Name

JEANNINE CARLA DOUGHERTY

Original Issue Date

12/07/1978

Effective Date

09/30/2004

Expiration Date

09/30/2006

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

11/08/2006