SHONA C TIETZ Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020008559

License Status

NOT RENEWED

Business

First Name

SHONA C

Last Name

TIETZ

Business Name

SHONA C TIETZ

Original Issue Date

08/02/1995

Effective Date

08/02/1995

Expiration Date

09/30/1998

City

BRADLEY

State

Zip

60915

County

KANKAKEE

Ever Disciplined

LastModifiedDate

10/12/2005