LATRICIA D KELLY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020010593

License Status

NOT RENEWED

Business

First Name

LATRICIA

Middle

Last Name

KELLY

Business Name

LATRICIA D KELLY

Original Issue Date

06/13/2003

Effective Date

09/30/2004

Expiration Date

09/30/2006

City

BELLEVILLE

State

Zip

62221

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

01/29/2007