NANCY BACKENKELL BURGESS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020001903

License Status

NOT RENEWED

Business

First Name

NANCY BACKENKELL

Last Name

BURGESS

Business Name

NANCY BACKENKELL BURGESS

Original Issue Date

07/11/1973

Effective Date

07/11/1973

Expiration Date

09/30/1998

City

MILWAUKEE

State

Zip

53202

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/12/2005