ALAN JAY NIDETZ DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****61

License Status

ACTIVE

Business

First Name

ALAN JAY

Last Name

NIDETZ

Suffix

DDS

Business Name

ALAN JAY NIDETZ DDS

Original Issue Date

07/17/1981

Effective Date

07/14/2024

Expiration Date

09/30/2027

City

SKOKIE

State

Zip

60077

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/14/2024