NICOLE MARIE BLACK Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020013510

License Status

ACTIVE

Business

First Name

NICOLE

Middle

MARIE

Last Name

BLACK

Business Name

NICOLE MARIE BLACK

Original Issue Date

04/22/2011

Effective Date

09/03/2024

Expiration Date

09/30/2027

City

CHANNAHON

State

Zip

60410

County

WILL

Ever Disciplined

LastModifiedDate

09/03/2024