LISA J H BLOXDORF Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020004171

License Status

NOT RENEWED

Business

First Name

LISA J H

Last Name

BLOXDORF

Business Name

LISA J H BLOXDORF

Original Issue Date

07/15/1980

Effective Date

04/30/2020

Expiration Date

01/31/2022

City

PLEASANT PRAIRIE

State

Zip

53158

County

WISCONSIN

Ever Disciplined

LastModifiedDate

05/09/2022