JILLIAN KAY BROKAW Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020010586

License Status

INACTIVE

Business

First Name

JILLIAN

Middle

KAY

Last Name

BROKAW

Business Name

JILLIAN KAY BROKAW

Original Issue Date

06/10/2003

Effective Date

10/02/2018

Expiration Date

12/31/2021

City

ALEDO

State

Zip

61231

County

MERCER

Ever Disciplined

LastModifiedDate

12/22/2021