TRACI LINN PAULSEN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****17

License Status

NOT RENEWED

Business

First Name

TRACI LINN

Last Name

PAULSEN

Suffix

DDS

Business Name

TRACI LINN PAULSEN DDS

Original Issue Date

04/10/1996

Effective Date

04/10/1996

Expiration Date

09/30/1998

City

FULTON

State

Zip

61252

County

WHITESIDE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005