THERESA L POLING Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020008887

License Status

NOT RENEWED

Business

First Name

THERESA L

Last Name

POLING

Business Name

THERESA L POLING

Original Issue Date

11/21/1996

Effective Date

11/21/1996

Expiration Date

09/30/1998

City

ST JOSEPH

State

Zip

61873

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/12/2005