JAY VINCENT LEWIS DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019016991

License Status

NOT RENEWED

Business

First Name

JAY VINCENT

Last Name

LEWIS

Suffix

DDS

Business Name

JAY VINCENT LEWIS DDS

Original Issue Date

10/12/1979

Effective Date

10/12/1979

Expiration Date

09/30/1986

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/12/2005