MATTHEW W MICKLE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020008518

License Status

NOT RENEWED

Business

First Name

MATTHEW W

Last Name

MICKLE

Business Name

MATTHEW W MICKLE

Original Issue Date

07/19/1995

Effective Date

10/01/2006

Expiration Date

09/30/2009

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Ever Disciplined

LastModifiedDate

11/04/2009