AUTUMN NICOLE HANSEN Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020015535

License Status

INACTIVE

Business

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

City

EAST MOLINE

State

Zip

61244

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

06/07/2018