MALLORY H MISIAK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020014507

License Status

NOT RENEWED

Business

First Name

MALLORY

Middle

Last Name

MISIAK

Business Name

MALLORY H MISIAK

Original Issue Date

09/16/2013

Effective Date

08/30/2018

Expiration Date

01/31/2022

City

WHITING

State

Zip

46394

County

INDIANA

Ever Disciplined

LastModifiedDate

05/09/2022