LANA THI TENGWALL Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020011921

License Status

NOT RENEWED

Business

First Name

LANA

Middle

THI

Last Name

TENGWALL

Business Name

LANA THI TENGWALL

Original Issue Date

11/08/2006

Effective Date

09/16/2015

Expiration Date

09/30/2018

City

RANTOUL

State

Zip

61866

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/31/2018