STEPHANIE LYN JENSEN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****99

License Status

NOT RENEWED

Business

First Name

STEPHANIE LYN

Last Name

JENSEN

Suffix

DDS

Business Name

STEPHANIE LYN JENSEN DDS

Original Issue Date

06/04/1996

Effective Date

06/04/1996

Expiration Date

09/30/1996

City

CHICAGO

State

Zip

60625

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005