LISA J CLARK Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020005287

License Status

INACTIVE

Business

First Name

LISA J

Last Name

CLARK

Business Name

LISA J CLARK

Original Issue Date

07/18/1983

Effective Date

07/18/1983

Expiration Date

09/30/1992

City

DOVER FOX CROFT

State

Zip

04426

County

MAINE

Ever Disciplined

LastModifiedDate

10/12/2005