MARYBETH T VILLA CROUCH Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020003254

License Status

NOT RENEWED

Business

First Name

MARYBETH T VILLA

Last Name

CROUCH

Business Name

MARYBETH T VILLA CROUCH

Original Issue Date

07/18/1977

Effective Date

07/18/1977

Expiration Date

09/30/1984

City

LOUISVILLE

State

Zip

40207

County

KENTUCKY

Ever Disciplined

LastModifiedDate

10/12/2005