JENNIFER MICHELLE WALLER SMITH DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****15

License Status

ACTIVE

Business

Title

DDS

First Name

JENNIFER

Middle

MICHELLE

Last Name

WALLER SMITH

Business Name

JENNIFER MICHELLE WALLER SMITH DDS

Original Issue Date

04/04/2017

Effective Date

09/07/2024

Expiration Date

09/30/2027

City

PRAIRIE VIEW

State

Zip

60069

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/07/2024