JANE A BERGMAN Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020005341

License Status

INACTIVE

Business

First Name

JANE A

Last Name

BERGMAN

Business Name

JANE A BERGMAN

Original Issue Date

08/02/1983

Effective Date

08/25/2015

Expiration Date

09/30/2018

City

CALEDONIA

State

Zip

61011

County

BOONE

Ever Disciplined

LastModifiedDate

06/07/2018