JENNIFER LYNN ANDERSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****75

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

LYNN

Last Name

ANDERSON

Suffix

DDS

Business Name

JENNIFER LYNN ANDERSON DDS

Original Issue Date

12/08/2010

Effective Date

11/02/2012

Expiration Date

09/30/2015

City

HUDSON

State

Zip

54016

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016