CRYSTAL G PROUTY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020005298

License Status

NOT RENEWED

Business

First Name

CRYSTAL G

Last Name

PROUTY

Business Name

CRYSTAL G PROUTY

Original Issue Date

07/25/1983

Effective Date

09/19/2018

Expiration Date

01/31/2022

City

MARQUETTE HEIGHTS

State

Zip

61554

County

TAZEWELL

Ever Disciplined

LastModifiedDate

05/09/2022