MICHELLE C FREDERICK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020007049

License Status

NOT RENEWED

Business

First Name

MICHELLE C

Last Name

FREDERICK

Business Name

MICHELLE C FREDERICK

Original Issue Date

08/30/1989

Effective Date

08/30/1989

Expiration Date

09/30/1998

City

SPRINGFIELD

State

Zip

62707

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/12/2005