DOROTHY DEMITRA POULOS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020010611

License Status

NOT RENEWED

Business

First Name

DOROTHY

Middle

DEMITRA

Last Name

POULOS

Business Name

DOROTHY DEMITRA POULOS

Original Issue Date

06/17/2003

Effective Date

09/06/2018

Expiration Date

01/31/2022

City

PLEASANT PRAIRIE

State

Zip

53158

County

WISCONSIN

Ever Disciplined

LastModifiedDate

05/09/2022