KIMBERLY LYNN FASULA Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020009530

License Status

ACTIVE

Business

First Name

KIMBERLY

Middle

LYNN

Last Name

FASULA

Business Name

KIMBERLY LYNN FASULA

Original Issue Date

07/02/1999

Effective Date

09/05/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60609

County

COOK

Ever Disciplined

LastModifiedDate

09/05/2024