TATUM L WIERSEMA Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020013708

License Status

ACTIVE

Business

First Name

TATUM

Middle

Last Name

WIERSEMA

Business Name

TATUM L WIERSEMA

Original Issue Date

07/19/2011

Effective Date

07/11/2024

Expiration Date

09/30/2027

City

FULTON

State

Zip

61252

County

WHITESIDE

Ever Disciplined

LastModifiedDate

07/11/2024