| 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 |