KELLY ANN BORNEMANN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020013845

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

ANN

Last Name

BORNEMANN

Business Name

KELLY ANN BORNEMANN

Original Issue Date

01/25/2012

Effective Date

08/14/2018

Expiration Date

01/31/2022

City

CHICAGO

State

Zip

60622

County

COOK

Ever Disciplined

LastModifiedDate

05/09/2022