KELLY GRIFFIN POTTORF Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020012766

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

GRIFFIN

Last Name

POTTORF

Business Name

KELLY GRIFFIN POTTORF

Original Issue Date

03/02/2009

Effective Date

03/02/2009

Expiration Date

09/30/2009

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

11/04/2009