SCOTT JARVIS SHUMWAY DDS Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001797

License Status

EXPIRED

Business

Title

DDS

First Name

SCOTT

Middle

JARVIS

Last Name

SHUMWAY

Business Name

SCOTT JARVIS SHUMWAY DDS

Original Issue Date

04/14/2011

Effective Date

04/14/2011

Expiration Date

06/30/2013

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/07/2013