SHELLEY V RIDER Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020011639

License Status

INACTIVE

Business

First Name

SHELLEY

Middle

Last Name

RIDER

Business Name

SHELLEY V RIDER

Original Issue Date

04/27/2006

Effective Date

09/30/2004

Expiration Date

09/30/2006

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

07/24/2006