DIANE P STALLARD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020004290

License Status

NOT RENEWED

Business

First Name

DIANE P

Last Name

STALLARD

Business Name

DIANE P STALLARD

Original Issue Date

07/30/1980

Effective Date

06/09/2009

Expiration Date

09/30/2012

City

BARRINGTON

State

Zip

60010

County

LAKE

Ever Disciplined

LastModifiedDate

11/14/2012