AUDREY CHILD KONICEK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020000281

License Status

NOT RENEWED

Business

First Name

AUDREY CHILD

Last Name

KONICEK

Business Name

AUDREY CHILD KONICEK

Original Issue Date

01/01/1998

City

NORTHAMPTON

State

Zip

01060

County

MASSACHUSETTS

Ever Disciplined

LastModifiedDate

10/12/2005