POONAM JAIN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

RESTRICTED FACULTY LICENSE

License Number

136000046

License Status

NOT RENEWED

Business

First Name

POONAM

Last Name

JAIN

Suffix

DDS

Business Name

POONAM JAIN DDS

Original Issue Date

06/30/1997

Effective Date

06/30/1997

Expiration Date

06/30/2000

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

10/13/2005