JENNIFER ELLEN NIEMZYK DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****63

License Status

NOT RENEWED

Business

Title

DDS

First Name

JENNIFER

Middle

ELLEN

Last Name

NIEMZYK

Business Name

JENNIFER ELLEN NIEMZYK DDS

Original Issue Date

06/09/2021

Effective Date

06/09/2021

Expiration Date

09/30/2024

City

LANSING

State

Zip

60438

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025