SOMER BLOSUM WAGGONER Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020016323

License Status

ACTIVE

Business

First Name

SOMER

Middle

BLOSUM

Last Name

WAGGONER

Business Name

SOMER BLOSUM WAGGONER

Original Issue Date

08/29/2018

Effective Date

07/05/2024

Expiration Date

09/30/2027

City

LAURA

State

Zip

61451

County

PEORIA

Ever Disciplined

LastModifiedDate

07/05/2024