NICOLE A FORGACH Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020010107

License Status

INACTIVE

Business

First Name

NICOLE

Middle

Last Name

FORGACH

Business Name

NICOLE A FORGACH

Original Issue Date

08/14/2001

Effective Date

09/30/2009

Expiration Date

09/30/2012

City

NOVI

State

Zip

48375

Ever Disciplined

LastModifiedDate

06/06/2012