MARIAH L THEIVAGT Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020015604

License Status

ACTIVE

Business

First Name

MARIAH

Middle

Last Name

THEIVAGT

Business Name

MARIAH L THEIVAGT

Original Issue Date

07/25/2016

Effective Date

09/26/2024

Expiration Date

09/30/2027

City

BEARDSTOWN

State

Zip

62618

County

CASS

Ever Disciplined

LastModifiedDate

09/26/2024