SHANNON MICHELLE LEWIS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001183

License Status

NOT RENEWED

Business

First Name

SHANNON

Middle

MICHELLE

Last Name

LEWIS

Business Name

SHANNON MICHELLE LEWIS

Original Issue Date

07/13/1999

Effective Date

07/13/1999

Expiration Date

06/30/2000

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005