LISA MARIA BLEVINS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020008970

License Status

NOT RENEWED

Business

First Name

LISA

Middle

MARIA

Last Name

BLEVINS

Business Name

LISA MARIA BLEVINS

Original Issue Date

07/04/1997

Effective Date

09/23/2009

Expiration Date

09/30/2012

City

PEKIN

State

Zip

61554

County

TAZEWELL

Ever Disciplined

LastModifiedDate

11/14/2012