JENNIFER JOHNSON BLUM Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020010721

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

JOHNSON

Last Name

BLUM

Business Name

JENNIFER JOHNSON BLUM

Original Issue Date

07/17/2003

Effective Date

09/30/2004

Expiration Date

09/30/2006

City

EVANSTON

State

Zip

60202

County

COOK

Ever Disciplined

LastModifiedDate

11/08/2006