JAMIE LYNN SMITH DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000764

License Status

NOT RENEWED

Business

First Name

JAMIE

Middle

LYNN

Last Name

SMITH

Suffix

DDS

Business Name

JAMIE LYNN SMITH DDS

Original Issue Date

08/25/2009

Effective Date

08/25/2009

Expiration Date

09/30/2012

City

PEORIA

State

Zip

61615

County

PEORIA

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

LastModifiedDate

11/14/2012