AMANDA JEAN LOSEY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020012634

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

JEAN

Last Name

LOSEY

Business Name

AMANDA JEAN LOSEY

Original Issue Date

07/28/2008

Effective Date

01/05/2010

Expiration Date

09/30/2012

City

GALESBURG

State

Zip

61401

County

KNOX

Ever Disciplined

LastModifiedDate

11/14/2012