JENNA NICOLE POLACEK DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****20

License Status

NOT RENEWED

Business

Title

DDS

First Name

JENNA

Middle

NICOLE

Last Name

POLACEK

Business Name

JENNA NICOLE POLACEK DDS

Original Issue Date

05/17/2016

Effective Date

05/17/2016

Expiration Date

09/30/2018

City

LOMBARD

State

Zip

60148

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018