SHEILA ANN HAVERTAPE Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020005451

License Status

INACTIVE

Business

First Name

SHEILA ANN

Last Name

HAVERTAPE

Business Name

SHEILA ANN HAVERTAPE

Original Issue Date

01/25/1984

Effective Date

10/01/2006

Expiration Date

09/30/2009

City

ROCKFORD

State

Zip

61111

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

06/04/2009