STACY NICOLE KNUTSON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020012760

License Status

NOT RENEWED

Business

First Name

STACY

Middle

NICOLE

Last Name

KNUTSON

Business Name

STACY NICOLE KNUTSON

Original Issue Date

02/09/2009

Effective Date

09/18/2012

Expiration Date

09/30/2015

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

04/25/2016