ANDRIA J MALLOY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020011883

License Status

NOT RENEWED

Business

First Name

ANDRIA

Middle

Last Name

MALLOY

Business Name

ANDRIA J MALLOY

Original Issue Date

09/14/2006

Effective Date

09/04/2012

Expiration Date

09/30/2015

City

GODFREY

State

Zip

62035

County

MADISON

Ever Disciplined

LastModifiedDate

04/25/2016