KIMBERLY S CUSACK Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020006436

License Status

ACTIVE

Business

First Name

KIMBERLY S

Last Name

CUSACK

Business Name

KIMBERLY S CUSACK

Original Issue Date

07/18/1987

Effective Date

05/20/2024

Expiration Date

09/30/2027

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Ever Disciplined

LastModifiedDate

05/20/2024