SAMANTHA RAQUEL LOGSDON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020009494

License Status

NOT RENEWED

Business

First Name

SAMANTHA

Middle

RAQUEL

Last Name

LOGSDON

Business Name

SAMANTHA RAQUEL LOGSDON

Original Issue Date

06/22/1999

Effective Date

06/22/1999

Expiration Date

09/30/2002

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/17/2005