ANDREA LYNN GIBAUD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020012254

License Status

NOT RENEWED

Business

First Name

ANDREA

Middle

LYNN

Last Name

GIBAUD

Business Name

ANDREA LYNN GIBAUD

Original Issue Date

08/09/2007

Effective Date

07/16/2009

Expiration Date

09/30/2012

City

FOREST PARK

State

Zip

60130

County

COOK

Ever Disciplined

LastModifiedDate

11/14/2012