JAKE WESLEY COLLINS DDS Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

RESTRICTED FACULTY LICENSE

License Number

136000118

License Status

EXPIRED

Business

First Name

JAKE

Middle

WESLEY

Last Name

COLLINS

Suffix

DDS

Business Name

JAKE WESLEY COLLINS DDS

Original Issue Date

07/31/2006

Effective Date

07/31/2006

Expiration Date

06/30/2008

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

07/31/2008