KELLIE M HOFFMAN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020011968

License Status

NOT RENEWED

Business

First Name

KELLIE

Middle

Last Name

HOFFMAN

Business Name

KELLIE M HOFFMAN

Original Issue Date

03/07/2007

Effective Date

09/22/2009

Expiration Date

09/30/2012

City

MURPHYSBORO

State

Zip

62966

County

JACKSON

Ever Disciplined

LastModifiedDate

11/14/2012