JANE FORSBERG JASEK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020005103

License Status

NOT RENEWED

Business

First Name

JANE

Last Name

FORSBERG JASEK

Business Name

JANE FORSBERG JASEK

Original Issue Date

01/03/1983

Effective Date

09/26/2018

Expiration Date

01/31/2022

City

CROWN POINT

State

Zip

46307

County

INDIANA

Ever Disciplined

LastModifiedDate

05/09/2022