STACY L MADLEM Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020006639

License Status

NOT RENEWED

Business

First Name

STACY L

Last Name

MADLEM

Business Name

STACY L MADLEM

Original Issue Date

07/29/1988

Effective Date

10/02/2018

Expiration Date

01/31/2022

City

CHARLESTON

State

Zip

61920

County

COLES

Ever Disciplined

LastModifiedDate

05/09/2022