JENNIFER NICOLE LAURENCE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****68

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

NICOLE

Last Name

LAURENCE

Business Name

JENNIFER NICOLE LAURENCE

Original Issue Date

11/16/2018

Effective Date

11/16/2018

Expiration Date

01/31/2022

City

SCOTT AFB

State

Zip

62225

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022