Wisconsin
Department of Safety and Professional Services
Province, Susan L
Dentistry
License number
5322-15
Date granted
03/13/2001
Date expires
09/30/2001
Class
Dentistry
Status
Expired
wisconsinlicensing.org
ID 35575894
LAST UPDATED 2026-04-12 08:00:39 UTC
LAST UPDATED 2026-04-12 08:00:39 UTC
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