JENNA NICOLE POLACEK DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001948

License Status

NOT RENEWED

Business

Title

DDS

First Name

JENNA

Middle

NICOLE

Last Name

POLACEK

Business Name

JENNA NICOLE POLACEK DDS

Original Issue Date

06/08/2015

Effective Date

07/01/2015

Expiration Date

06/30/2016

City

LOMBARD

State

Zip

60148

County

DUPAGE

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

03/09/2017