JILL LAVERN MANVILLA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020002814

License Status

NOT RENEWED

Business

First Name

JILL LAVERN

Last Name

MANVILLA

Business Name

JILL LAVERN MANVILLA

Original Issue Date

07/13/1976

Effective Date

07/13/1976

Expiration Date

09/30/1984

City

CROWN POINT

State

Zip

46307

County

INDIANA

Ever Disciplined

LastModifiedDate

10/12/2005