KRISTY LYNN BURGOS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020016101

License Status

NOT RENEWED

Business

First Name

KRISTY

Middle

LYNN

Last Name

BURGOS

Business Name

KRISTY LYNN BURGOS

Original Issue Date

03/19/2018

Effective Date

03/19/2018

Expiration Date

09/30/2018

City

DEMOTTE

State

Zip

46310

Ever Disciplined

LastModifiedDate

10/31/2018