MICHELLE LEE BROUILLETTE Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020010638

License Status

INACTIVE

Business

First Name

MICHELLE

Middle

LEE

Last Name

BROUILLETTE

Business Name

MICHELLE LEE BROUILLETTE

Original Issue Date

06/25/2003

Effective Date

10/01/2006

Expiration Date

09/30/2009

City

GRAFTON

State

Zip

53024

County

WISCONSIN

Ever Disciplined

LastModifiedDate

06/04/2009