KATY G BROCK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020011903

License Status

NOT RENEWED

Business

First Name

KATY

Middle

Last Name

BROCK

Business Name

KATY G BROCK

Original Issue Date

10/11/2006

Effective Date

08/16/2018

Expiration Date

01/31/2022

City

CHICAGO

State

Zip

60625

County

COOK

Ever Disciplined

LastModifiedDate

05/09/2022