SUSAN SHORE VIGNOLA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019016683

License Status

NOT RENEWED

Business

First Name

SUSAN SHORE

Last Name

VIGNOLA

Suffix

DDS

Business Name

SUSAN SHORE VIGNOLA DDS

Original Issue Date

06/29/1979

Effective Date

06/29/1979

Expiration Date

09/30/1988

City

PORTAGE

State

Zip

46368

County

INDIANA

Ever Disciplined

LastModifiedDate

10/12/2005