KIIRI TAMM TIETJENS DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000677

License Status

NOT RENEWED

Business

First Name

KIIRI

Middle

TAMM

Last Name

TIETJENS

Suffix

DDS

Business Name

KIIRI TAMM TIETJENS DDS

Original Issue Date

06/28/2006

Effective Date

09/11/2021

Expiration Date

09/30/2024

City

BOURBONNAIS

State

Zip

60914

County

KANKAKEE

Ever Disciplined

LastModifiedDate

02/04/2025