JAY JAMES GEISTKEMPER DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****13

License Status

NOT RENEWED

Business

First Name

JAY JAMES

Last Name

GEISTKEMPER

Suffix

DMD

Business Name

JAY JAMES GEISTKEMPER DMD

Original Issue Date

08/14/2001

Effective Date

08/14/2001

Expiration Date

09/30/2004

City

CHICAGO

State

Zip

60656

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005