THOMAS JAY HEIDENREICH DDS Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

RESTRICTED FACULTY LICENSE

License Number

136000219

License Status

EXPIRED

Business

Title

DDS

First Name

THOMAS

Middle

JAY

Last Name

HEIDENREICH

Business Name

THOMAS JAY HEIDENREICH DDS

Original Issue Date

08/10/2017

Effective Date

08/10/2017

Expiration Date

06/30/2020

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

11/19/2020