| 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 |