LISA C KIRK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020011109

License Status

NOT RENEWED

Business

First Name

LISA

Middle

Last Name

KIRK

Business Name

LISA C KIRK

Original Issue Date

08/02/2004

Effective Date

02/17/2011

Expiration Date

09/30/2012

City

WATERLOO

State

Zip

62298

County

MONROE

Ever Disciplined

LastModifiedDate

11/14/2012