MELANIE SUZANNE DIEBOLD - Dentist License in Illinois | # 020011522

MELANIE SUZANNE DIEBOLD

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020011522

License Status

NOT RENEWED

Business

N

First Name

MELANIE

Middle

SUZANNE

Last Name

DIEBOLD

Business Name

MELANIE SUZANNE DIEBOLD

Original Issue Date

09/16/2005

Effective Date

08/18/2015

Expiration Date

09/30/2018

State

IL

Ever Disciplined

N

LastModifiedDate

10/31/2018