NICHOLE MARIE PETTYJOHN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020010350

License Status

NOT RENEWED

Business

First Name

NICHOLE

Middle

MARIE

Last Name

PETTYJOHN

Business Name

NICHOLE MARIE PETTYJOHN

Original Issue Date

07/01/2002

Effective Date

06/25/2018

Expiration Date

01/31/2022

City

DECATUR

State

Zip

62521

County

MACON

Ever Disciplined

LastModifiedDate

05/09/2022