GLORIA ELAINE BEANBLOSSOM Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020004359

License Status

NOT RENEWED

Business

First Name

GLORIA ELAINE

Last Name

BEANBLOSSOM

Business Name

GLORIA ELAINE BEANBLOSSOM

Original Issue Date

09/15/1980

Effective Date

09/15/1980

Expiration Date

09/30/1992

City

STANFORD

State

Zip

61774

County

MCLEAN

Ever Disciplined

LastModifiedDate

10/12/2005