Licensee Name: | BLACKMUN MARILYN |
License Type: | REGISTERED DENTAL HYGIENIST IN ALTERNATIVE PRACTICE |
License Number: | 11 |
License Status: | INACTIVE Definition |
Expiration Date: | November 30, 2015 |
Issue Date: | October 22, 1998 |
License or Registration Class: | SLN |
County: | LOS ANGELES |
Actions: | No |