MARY E JORSTAD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020005111

License Status

NOT RENEWED

Business

First Name

MARY E

Last Name

JORSTAD

Business Name

MARY E JORSTAD

Original Issue Date

01/17/1983

Effective Date

08/17/2015

Expiration Date

09/30/2018

City

CHARLESTON

State

Zip

61920

County

COLES

Ever Disciplined

LastModifiedDate

10/31/2018