LORI R BLAZER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020006967

License Status

NOT RENEWED

Business

First Name

LORI R

Last Name

BLAZER

Business Name

LORI R BLAZER

Original Issue Date

08/01/1989

Effective Date

08/12/2015

Expiration Date

09/30/2018

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Ever Disciplined

LastModifiedDate

10/31/2018