MARY ELLEN GOAZ Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020002241

License Status

NOT RENEWED

Business

First Name

MARY ELLEN

Last Name

GOAZ

Business Name

MARY ELLEN GOAZ

Original Issue Date

07/03/1974

Effective Date

07/03/1974

City

FORT WORTH

State

Zip

76116

County

TEXAS

Ever Disciplined

LastModifiedDate

10/12/2005