MARILYN JEAN HAVENGA Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020002214

License Status

INACTIVE

Business

First Name

MARILYN JEAN

Last Name

HAVENGA

Business Name

MARILYN JEAN HAVENGA

Original Issue Date

07/03/1974

Effective Date

07/03/1974

Expiration Date

09/30/2000

City

OCONOMOWOC

State

Zip

53066

Ever Disciplined

LastModifiedDate

10/17/2005