SOUKSAKHONE SOURIGNAVONG Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020010550

License Status

NOT RENEWED

Business

First Name

SOUKSAKHONE

Last Name

SOURIGNAVONG

Business Name

SOUKSAKHONE SOURIGNAVONG

Original Issue Date

02/28/2003

Effective Date

10/01/2006

Expiration Date

09/30/2009

City

TUSTIN

State

Zip

49688

County

MICHIGAN

Ever Disciplined

LastModifiedDate

11/04/2009