JENNIFER L THIEL DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****15

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

Last Name

THIEL

Suffix

DDS

Business Name

JENNIFER L THIEL DDS

Original Issue Date

09/08/2004

Effective Date

09/08/2004

Expiration Date

09/30/2006

City

EFFINGHAM

State

Zip

62401

County

EFFINGHAM

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2006