SUSAN CAROL LEWIS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020000936

License Status

INACTIVE

Business

First Name

SUSAN CAROL

Last Name

LEWIS

Business Name

SUSAN CAROL LEWIS

Original Issue Date

07/20/1967

Effective Date

09/17/2012

Expiration Date

09/30/2015

City

HIGHLAND PARK

State

Zip

60035

County

LAKE

Ever Disciplined

LastModifiedDate

06/08/2015