TAMALA JEAN PETERSON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020004470

License Status

NOT RENEWED

Business

First Name

TAMALA JEAN

Last Name

PETERSON

Business Name

TAMALA JEAN PETERSON

Original Issue Date

06/15/1981

Effective Date

08/20/2018

Expiration Date

01/31/2022

City

BELOIT

State

Zip

53511

County

WISCONSIN

Ever Disciplined

LastModifiedDate

05/09/2022