JEAN A LEWIS DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****02

License Status

NOT RENEWED

Business

Title

DMD

First Name

JEAN

Middle

Last Name

LEWIS

Business Name

JEAN A LEWIS DMD

Original Issue Date

10/30/2002

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

CHICAGO

State

Zip

60622

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009