AMY B KLOMP Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020011027

License Status

INACTIVE

Business

First Name

AMY

Middle

Last Name

KLOMP

Business Name

AMY B KLOMP

Original Issue Date

06/25/2004

Effective Date

10/01/2012

Expiration Date

09/30/2015

City

CEDAR LAKE

State

Zip

46303

County

INDIANA

Ever Disciplined

LastModifiedDate

06/08/2015