Nicole Faith Koontz
InactiveIllinois license 020014279
License
- Licensed by
- Illinois Department of Financial and Professional Regulation
- License number
- 020014279
- Status
- Inactive
- First issued
- May 23, 2013
- Expired
- September 30, 2015
- License holder
- Nicole Faith Koontz
- Entity type
- Individual
Classifications
- Registered Dental Hygienist Dental
More from the license record
- Current term began
- 05/23/2013
Contact
Fort Atkinson, WI 53538
Wisconsin County