PHYLLIS A STALEY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020008273

License Status

NOT RENEWED

Business

First Name

PHYLLIS A

Last Name

STALEY

Business Name

PHYLLIS A STALEY

Original Issue Date

07/14/1994

Effective Date

07/14/1994

Expiration Date

09/30/2000

City

ELSAH

State

Zip

62028

County

JERSEY

Ever Disciplined

LastModifiedDate

10/17/2005