PATRICIA MCCUBBINS PARK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020004993

License Status

NOT RENEWED

Business

First Name

PATRICIA

Middle

MCCUBBINS

Last Name

PARK

Business Name

PATRICIA MCCUBBINS PARK

Original Issue Date

08/03/1982

Effective Date

06/19/2012

Expiration Date

09/30/2015

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

04/25/2016