LISA ANN LATHAM Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020005688

License Status

ACTIVE

Business

First Name

LISA ANN

Last Name

LATHAM

Business Name

LISA ANN LATHAM

Original Issue Date

09/10/1984

Effective Date

07/25/2024

Expiration Date

09/30/2027

City

LAKEMOOR

State

Zip

60051

Ever Disciplined

LastModifiedDate

07/25/2024