NICOLE A NIEWDACH DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****23

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

Last Name

NIEWDACH

Suffix

DDS

Business Name

NICOLE A NIEWDACH DDS

Original Issue Date

03/16/2015

Effective Date

11/24/2015

Expiration Date

09/30/2018

City

SAINT LOUIS

State

Zip

63124

County

MISSOURI

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018