LYDIA CAROLYN BLANKSCHAEN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020012572

License Status

NOT RENEWED

Business

First Name

LYDIA

Middle

CAROLYN

Last Name

BLANKSCHAEN

Business Name

LYDIA CAROLYN BLANKSCHAEN

Original Issue Date

07/02/2008

Effective Date

09/11/2009

Expiration Date

09/30/2012

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

11/14/2012