CHRISTINA M A SMITH Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020011101

License Status

NOT RENEWED

Business

First Name

CHRISTINA

Middle

M A

Last Name

SMITH

Business Name

CHRISTINA M A SMITH

Original Issue Date

07/28/2004

Effective Date

09/28/2009

Expiration Date

09/30/2012

City

HIGHLAND

State

Zip

62249

County

MADISON

Ever Disciplined

LastModifiedDate

11/14/2012