JACQUELIN D ADAM-BALBOA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020015384

License Status

NOT RENEWED

Business

First Name

JACQUELIN

Middle

Last Name

ADAM-BALBOA

Business Name

JACQUELIN D ADAM-BALBOA

Original Issue Date

03/25/2016

Effective Date

03/25/2016

Expiration Date

09/30/2018

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

10/31/2018