MARY JEAN KOTLEBA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020003897

License Status

NOT RENEWED

Business

First Name

MARY JEAN

Last Name

KOTLEBA

Business Name

MARY JEAN KOTLEBA

Original Issue Date

07/10/1979

Effective Date

07/10/1979

Expiration Date

09/30/1988

City

SEATTLE

State

Zip

98103

County

WASHINGTON

Ever Disciplined

LastModifiedDate

10/12/2005