JOANNA M WALLACE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020007565

License Status

NOT RENEWED

Business

First Name

JOANNA M

Last Name

WALLACE

Business Name

JOANNA M WALLACE

Original Issue Date

10/08/1991

Effective Date

10/08/1991

Expiration Date

09/30/1992

City

LAPORTE

State

Zip

46350

County

INDIANA

Ever Disciplined

LastModifiedDate

10/12/2005