MARY BETH BAZHENOW Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020004231

License Status

NOT RENEWED

Business

First Name

MARY BETH

Last Name

BAZHENOW

Business Name

MARY BETH BAZHENOW

Original Issue Date

07/17/1980

Effective Date

09/25/2021

Expiration Date

09/30/2024

City

PEORIA

State

Zip

61604

County

PEORIA

Ever Disciplined

LastModifiedDate

02/04/2025