SCOTT ALBERT JENSEN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****97

License Status

NOT RENEWED

Business

First Name

SCOTT ALBERT

Last Name

JENSEN

Business Name

SCOTT ALBERT JENSEN

Original Issue Date

09/12/2011

Effective Date

10/02/2012

Expiration Date

09/30/2015

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

02/08/2016