BETHANY ELLEN DIEWALD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020010225

License Status

ACTIVE

Business

First Name

BETHANY

Middle

ELLEN

Last Name

DIEWALD

Business Name

BETHANY ELLEN DIEWALD

Original Issue Date

02/01/2002

Effective Date

09/12/2024

Expiration Date

09/30/2027

City

RED BUD

State

Zip

62278

County

RANDOLPH

Ever Disciplined

LastModifiedDate

09/12/2024