MARTHA MODEL Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020007053

License Status

ACTIVE

Business

First Name

MARTHA

Last Name

MODEL

Business Name

MARTHA MODEL

Original Issue Date

09/02/1989

Effective Date

07/09/2024

Expiration Date

09/30/2027

City

GRAYSLAKE

State

Zip

60030

County

LAKE

Ever Disciplined

LastModifiedDate

07/09/2024