KIMBERLY JEAN AUDETAT Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020012684

License Status

INACTIVE

Business

First Name

KIMBERLY

Middle

JEAN

Last Name

AUDETAT

Business Name

KIMBERLY JEAN AUDETAT

Original Issue Date

09/18/2008

Effective Date

09/26/2012

Expiration Date

09/30/2015

City

LAKE GENEVA

State

Zip

53147

County

WISCONSIN

Ever Disciplined

LastModifiedDate

06/08/2015