SAMANTHA LYNN JANSEN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020008914

License Status

NOT RENEWED

Business

First Name

SAMANTHA LYNN

Last Name

JANSEN

Business Name

SAMANTHA LYNN JANSEN

Original Issue Date

03/05/1997

Effective Date

10/01/2012

Expiration Date

09/30/2015

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

04/25/2016