Tarisa Celeste Shake
ExpiredIllinois license 020003821
License
- Licensed by
- Illinois Department of Financial and Professional Regulation
- License number
- 020003821
- Status
- Expired (Not Renewed)
- First issued
- June 29, 1979
- Expired
- September 30, 2002
- License holder
- Tarisa Celeste Shake
- Entity type
- Individual
Classifications
- Registered Dental Hygienist Dental
More from the license record
- Current term began
- 06/29/1979
Contact
Boise, ID 83704
Idaho County