Patricia Diane Bouman
ExpiredIllinois license 020004319
License
- Licensed by
- Illinois Department of Financial and Professional Regulation
- License number
- 020004319
- Status
- Expired (Not Renewed)
- First issued
- August 15, 1980
- Expired
- April 1, 1982
- License holder
- Patricia Diane Bouman
- Entity type
- Individual
Classifications
- Registered Dental Hygienist Dental
More from the license record
- Current term began
- 08/15/1980
Contact
Belleville, IL 62223
Saint Clair County