BENITA THEIS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020005769

License Status

INACTIVE

Business

First Name

BENITA

Last Name

THEIS

Business Name

BENITA THEIS

Original Issue Date

06/20/1985

Effective Date

06/20/1985

Expiration Date

09/30/1992

City

WAUKESHA

State

Zip

53186

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/12/2005