ALYSSA ANN BLACK Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020013904

License Status

ACTIVE

Business

First Name

ALYSSA

Middle

ANN

Last Name

BLACK

Business Name

ALYSSA ANN BLACK

Original Issue Date

05/30/2012

Effective Date

05/31/2024

Expiration Date

09/30/2027

City

HERRICK

State

Zip

62431

County

FAYETTE

Ever Disciplined

LastModifiedDate

05/31/2024