KELLY T LANE Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020005830

License Status

INACTIVE

Business

First Name

KELLY T

Last Name

LANE

Business Name

KELLY T LANE

Original Issue Date

07/19/1985

Effective Date

07/19/1985

Expiration Date

09/30/2004

City

CHESTERFIELD

State

Zip

60335

County

MISSOURI

Ever Disciplined

LastModifiedDate

10/17/2005