AUTUMN NICOLE HANSEN - Dentist License in Illinois | # 020015535

AUTUMN NICOLE HANSEN

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020015535

License Status

INACTIVE

Business

N

First Name

AUTUMN

Middle

NICOLE

Last Name

HANSEN

Business Name

AUTUMN NICOLE HANSEN

Original Issue Date

07/08/2016

Effective Date

07/08/2016

Expiration Date

09/30/2018

State

IL

Ever Disciplined

N

LastModifiedDate

06/07/2018