KELLEY J FERGUSON Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020007731

License Status

INACTIVE

Business

First Name

KELLEY J

Last Name

FERGUSON

Business Name

KELLEY J FERGUSON

Original Issue Date

07/20/1992

Effective Date

07/20/1992

Expiration Date

09/30/1996

City

MINOCQUA

State

Zip

54548

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/12/2005