NICOLE L BLACK Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020013600

License Status

ACTIVE

Business

First Name

NICOLE

Middle

Last Name

BLACK

Business Name

NICOLE L BLACK

Original Issue Date

07/06/2011

Effective Date

09/30/2024

Expiration Date

09/30/2027

City

ROCHESTER

State

Zip

62563

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/30/2024