MARY SUE SMITH Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020003788

License Status

INACTIVE

Business

First Name

MARY SUE

Last Name

SMITH

Business Name

MARY SUE SMITH

Original Issue Date

06/21/1979

Effective Date

10/14/2009

Expiration Date

09/30/2012

City

QUINCY

State

Zip

62305

County

ADAMS

Ever Disciplined

LastModifiedDate

06/06/2012