PATRICE MARIE JOHNSON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020003976

License Status

NOT RENEWED

Business

First Name

PATRICE MARIE

Last Name

JOHNSON

Business Name

PATRICE MARIE JOHNSON

Original Issue Date

08/17/1979

Effective Date

08/17/1979

Expiration Date

04/01/1982

City

PEORIA

State

Zip

61604

County

PEORIA

Ever Disciplined

LastModifiedDate

10/12/2005