KELLY M SPAGNA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020013399

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

Last Name

SPAGNA

Business Name

KELLY M SPAGNA

Original Issue Date

08/27/2010

Effective Date

10/03/2012

Expiration Date

09/30/2015

City

VALPARAISO

State

Zip

46385

County

INDIANA

Ever Disciplined

LastModifiedDate

04/25/2016