KELLY S BACON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020006185

License Status

NOT RENEWED

Business

First Name

KELLY S

Last Name

BACON

Business Name

KELLY S BACON

Original Issue Date

07/30/1986

Effective Date

07/30/1986

Expiration Date

09/30/1994

City

CHARLESTON

State

Zip

61920

County

COLES

Ever Disciplined

LastModifiedDate

10/12/2005