AMANDA NICHOLE LONGTIN Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020014424

License Status

INACTIVE

Business

First Name

AMANDA

Middle

NICHOLE

Last Name

LONGTIN

Business Name

AMANDA NICHOLE LONGTIN

Original Issue Date

07/26/2013

Effective Date

08/20/2018

Expiration Date

09/30/2021

City

MCCORDSVILLE

State

Zip

46055

County

WILL

Ever Disciplined

LastModifiedDate

08/20/2018