CONSTANCE ELLEN BAUM Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020003632

License Status

NOT RENEWED

Business

First Name

CONSTANCE ELLEN

Last Name

BAUM

Business Name

CONSTANCE ELLEN BAUM

Original Issue Date

07/21/1978

Effective Date

07/21/1978

Expiration Date

09/30/1996

City

MOUNT HEREB

State

Zip

53572

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/12/2005