| Licensee Name: | JACQUES ANNETTE LAURA |
| License Type: | REGISTERED DENTAL HYGIENIST |
| License Number: | 9676 |
| License Status: | CANCELLED Definition |
| Expiration Date: | January 31, 1984 |
| Issue Date: | May 17, 1981 |
| License or Registration Class: | NON |
| County: | OUT OF STATE |
| Actions: | No |