MARY E TIERNEY DDS - Dentist License in Illinois | # 137000490

MARY E TIERNEY DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000490

License Status

NOT RENEWED

Business

N

First Name

MARY

Middle

E

Last Name

TIERNEY

Suffix

DDS

Business Name

MARY E TIERNEY DDS

Original Issue Date

12/03/1999

Effective Date

08/24/2009

Expiration Date

09/30/2012

State

IL

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

N

LastModifiedDate

11/14/2012