KIMBERLY A FULLERTON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020006354

License Status

NOT RENEWED

Business

First Name

KIMBERLY A

Last Name

FULLERTON

Business Name

KIMBERLY A FULLERTON

Original Issue Date

06/06/1987

Effective Date

06/06/1987

Expiration Date

09/30/1994

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/12/2005