CHRISTEN J NIELSEN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****63

License Status

NOT RENEWED

Business

First Name

CHRISTEN J

Last Name

NIELSEN

Business Name

CHRISTEN J NIELSEN

Original Issue Date

12/12/1995

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

GLEN CARBON

State

Zip

62304

County

MADISON

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

11/04/2009