ALYSSA BRIANNA TIPSWORD KIZER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020015497

License Status

NOT RENEWED

Business

First Name

ALYSSA

Middle

BRIANNA

Last Name

TIPSWORD KIZER

Business Name

ALYSSA BRIANNA TIPSWORD KIZER

Original Issue Date

07/06/2016

Effective Date

07/06/2016

Expiration Date

09/30/2018

City

CHAMPAGIN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/31/2018