CONRAD E NIELSEN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****61

License Status

NOT RENEWED

Business

First Name

CONRAD E

Last Name

NIELSEN

Suffix

DDS

Business Name

CONRAD E NIELSEN DDS

Original Issue Date

11/01/1983

Effective Date

07/08/2009

Expiration Date

09/30/2012

City

CLAYTON

State

Zip

62324

County

ADAMS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012