MARISSA ANN MARIE CLARK Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020016142

License Status

ACTIVE

Business

First Name

MARISSA

Middle

ANN MARIE

Last Name

CLARK

Business Name

MARISSA ANN MARIE CLARK

Original Issue Date

06/13/2018

Effective Date

05/01/2024

Expiration Date

09/30/2027

City

CHANA

State

Zip

61015

County

OGLE

Ever Disciplined

LastModifiedDate

09/28/2024