SHANA LYN PETERSON Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020010613

License Status

ACTIVE

Business

First Name

SHANA

Middle

LYN

Last Name

PETERSON

Business Name

SHANA LYN PETERSON

Original Issue Date

06/17/2003

Effective Date

09/13/2024

Expiration Date

09/30/2027

City

ROCKFORD

State

Zip

61109

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

09/13/2024