KELLY L HAUSSMANN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020007981

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

Last Name

HAUSSMANN

Business Name

KELLY L HAUSSMANN

Original Issue Date

07/27/1993

Effective Date

07/02/2009

Expiration Date

09/30/2012

City

CRYSTAL LAKE

State

Zip

60014

Ever Disciplined

LastModifiedDate

11/14/2012