TYLER JAMES JACQUES Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****06

License Status

NOT RENEWED

Business

First Name

TYLER

Middle

JAMES

Last Name

JACQUES

Business Name

TYLER JAMES JACQUES

Original Issue Date

09/16/2011

Effective Date

07/24/2015

Expiration Date

09/30/2018

City

WASHINGTON

State

Zip

20003

County

DISTRICT OF COLUMBIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018