AMANDA GRACE WALTNER Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020017565

License Status

ACTIVE

Business

First Name

AMANDA

Middle

GRACE

Last Name

WALTNER

Business Name

AMANDA GRACE WALTNER

Original Issue Date

05/19/2022

Effective Date

08/24/2024

Expiration Date

09/30/2027

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

08/24/2024