JAY MARSHALL SUVERKRUP DMD Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****25

License Status

CANCELLED

Business

First Name

JAY MARSHALL

Last Name

SUVERKRUP

Suffix

DMD

Business Name

JAY MARSHALL SUVERKRUP DMD

Original Issue Date

01/01/1998

Expiration Date

06/01/1982

City

DAVENPORT

State

Zip

52807

County

IOWA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005