Licensee Name: | FAIRCHILD RETA |
License Type: | REGISTERED DENTAL HYGIENIST |
License Number: | 896 |
License Status: | CANCELLED Definition |
Expiration Date: | January 31, 1997 |
Issue Date: | July 23, 1956 |
License or Registration Class: | SLN |
County: | OUT OF STATE |
Actions: | No |