TERRIE LYNN POLZIN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020004049

License Status

NOT RENEWED

Business

First Name

TERRIE LYNN

Last Name

POLZIN

Business Name

TERRIE LYNN POLZIN

Original Issue Date

11/05/1979

Effective Date

08/19/2015

Expiration Date

09/30/2018

City

DEWEY

State

Zip

61840

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/31/2018