KRYSTIN L WAGNER - Dentist License in Illinois | # 020011624

KRYSTIN L WAGNER

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020011624

License Status

NOT RENEWED

Business

N

First Name

KRYSTIN

Middle

L

Last Name

WAGNER

Business Name

KRYSTIN L WAGNER

Original Issue Date

03/22/2006

Effective Date

10/01/2006

Expiration Date

09/30/2009

State

IL

Ever Disciplined

N

LastModifiedDate

11/04/2009