SANDRA MICHELLE PEACOCK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020010398

License Status

NOT RENEWED

Business

First Name

SANDRA

Middle

MICHELLE

Last Name

PEACOCK

Business Name

SANDRA MICHELLE PEACOCK

Original Issue Date

07/17/2002

Effective Date

07/17/2002

Expiration Date

09/30/2004

City

CANANDAIGUA

State

Zip

14424

County

NEW YORK

Ever Disciplined

LastModifiedDate

10/17/2005