JENNIFER L WIENS DDS Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001336

License Status

EXPIRED

Business

First Name

JENNIFER

Middle

Last Name

WIENS

Suffix

DDS

Business Name

JENNIFER L WIENS DDS

Original Issue Date

06/04/2002

Effective Date

06/04/2002

Expiration Date

06/30/2003

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005