COREY DANE KONIECZKI DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019033117

License Status

ACTIVE

Business

Title

DMD

First Name

COREY

Middle

DANE

Last Name

KONIECZKI

Business Name

COREY DANE KONIECZKI DMD

Original Issue Date

06/02/2021

Effective Date

05/02/2024

Expiration Date

09/30/2027

City

CALEDONIA

State

Zip

61011

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/02/2024