JAY IVOR SWANSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000303

License Status

NOT RENEWED

Business

First Name

JAY

Middle

IVOR

Last Name

SWANSON

Suffix

DDS

Business Name

JAY IVOR SWANSON DDS

Original Issue Date

11/26/1991

Effective Date

11/26/1991

Expiration Date

09/30/2006

City

MATTOON

State

Zip

61938

County

COLES

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

LastModifiedDate

11/08/2006