GABRIELLE ANN SLACK Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020016917

License Status

ACTIVE

Business

First Name

GABRIELLE

Middle

ANN

Last Name

SLACK

Business Name

GABRIELLE ANN SLACK

Original Issue Date

08/21/2020

Effective Date

08/31/2024

Expiration Date

09/30/2027

City

MAHOMET

State

Zip

61853

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

08/31/2024