PATRICIA DIANE BOUMAN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020004319

License Status

NOT RENEWED

Business

First Name

PATRICIA DIANE

Last Name

BOUMAN

Business Name

PATRICIA DIANE BOUMAN

Original Issue Date

08/15/1980

Effective Date

08/15/1980

Expiration Date

04/01/1982

City

BELLEVILLE

State

Zip

62223

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

10/12/2005