STACY D SMITH Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020008106

License Status

NOT RENEWED

Business

First Name

STACY D

Last Name

SMITH

Business Name

STACY D SMITH

Original Issue Date

09/24/1993

Effective Date

09/21/2009

Expiration Date

09/30/2012

City

HAVANA

State

Zip

62644

County

MASON

Ever Disciplined

LastModifiedDate

11/14/2012