JONATHAN ARTHUR PENZIEN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001206

License Status

NOT RENEWED

Business

First Name

JONATHAN

Middle

ARTHUR

Last Name

PENZIEN

Suffix

DDS

Business Name

JONATHAN ARTHUR PENZIEN DDS

Original Issue Date

05/26/2000

Effective Date

05/26/2000

Expiration Date

06/30/2001

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005