Jacquelyn Nancy Johansen
InactiveIllinois license 020009641
License
- Licensed by
- Illinois Department of Financial and Professional Regulation
- License number
- 020009641
- Status
- Inactive
- First issued
- October 6, 1999
- Expired
- September 30, 2012
- License holder
- Jacquelyn Nancy Johansen
- Entity type
- Individual
Classifications
- Registered Dental Hygienist Dental
More from the license record
- Current term began
- 06/18/2009
Contact
Tualatin, OR 97062
Washington County