TANYA LYNNE NIELSEN DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****88

License Status

ACTIVE

Business

Title

DDS

First Name

TANYA

Middle

LYNNE

Last Name

NIELSEN

Business Name

TANYA LYNNE NIELSEN DDS

Original Issue Date

04/30/2015

Effective Date

09/17/2024

Expiration Date

09/30/2027

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/17/2024