THOMAS JAY HEIDENREICH DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000999

License Status

NOT RENEWED

Business

Title

DDS

First Name

THOMAS

Middle

JAY

Last Name

HEIDENREICH

Business Name

THOMAS JAY HEIDENREICH DDS

Original Issue Date

01/22/2018

Effective Date

06/15/2018

Expiration Date

01/31/2022

City

SCOTT AFB

State

Zip

62225

County

SAINT CLAIR

Specialty/Qualifier

DEEP SEDATION AND GENERAL ANESTHESIA

Ever Disciplined

LastModifiedDate

05/09/2022