NANCY L MIX Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020006966

License Status

INACTIVE

Business

First Name

NANCY L

Last Name

MIX

Business Name

NANCY L MIX

Original Issue Date

08/01/1989

Effective Date

09/30/2004

Expiration Date

09/30/2006

City

PLEASANT PEAIRIE

State

Zip

53158

County

WISCONSIN

Ever Disciplined

LastModifiedDate

07/24/2006