JENNIFER M HIVELY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020011099

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

Last Name

HIVELY

Business Name

JENNIFER M HIVELY

Original Issue Date

07/28/2004

Effective Date

07/30/2009

Expiration Date

09/30/2012

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

11/14/2012