TRACEY LYNN CLARK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020009614

License Status

NOT RENEWED

Business

First Name

TRACEY

Middle

LYNN

Last Name

CLARK

Business Name

TRACEY LYNN CLARK

Original Issue Date

08/27/1999

Effective Date

08/27/1999

Expiration Date

09/30/2002

City

HAMMOND

State

Zip

46323

County

INDIANA

Ever Disciplined

LastModifiedDate

10/17/2005