TARA E WAYNE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020011142

License Status

NOT RENEWED

Business

First Name

TARA

Middle

Last Name

WAYNE

Business Name

TARA E WAYNE

Original Issue Date

08/18/2004

Effective Date

10/01/2006

Expiration Date

09/30/2009

City

LE ROY

State

Zip

61752

County

MCLEAN

Ever Disciplined

LastModifiedDate

11/04/2009