AUTUMN MARIE SMITH - Dentist License in Illinois | # 020012966

AUTUMN MARIE SMITH

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020012966

License Status

NOT RENEWED

Business

N

First Name

AUTUMN

Middle

MARIE

Last Name

SMITH

Business Name

AUTUMN MARIE SMITH

Original Issue Date

07/01/2009

Effective Date

07/01/2009

Expiration Date

09/30/2012

State

IL

Ever Disciplined

N

LastModifiedDate

11/14/2012