STEPHANIE NICOLE HENRICKS DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****00

License Status

ACTIVE

Business

Title

DMD

First Name

STEPHANIE

Middle

NICOLE

Last Name

HENRICKS

Business Name

STEPHANIE NICOLE HENRICKS DMD

Original Issue Date

07/17/2014

Effective Date

08/24/2024

Expiration Date

09/30/2027

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/24/2024