SUSAN M SELF Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020007259

License Status

NOT RENEWED

Business

First Name

SUSAN M

Last Name

SELF

Business Name

SUSAN M SELF

Original Issue Date

08/22/1990

Effective Date

06/15/2009

Expiration Date

09/30/2012

City

ALEXANDRIA

State

Zip

22314

County

VIRGINIA

Ever Disciplined

LastModifiedDate

11/14/2012