JAMIE L SWANSON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****18

License Status

NOT RENEWED

Business

First Name

JAMIE L

Last Name

SWANSON

Business Name

JAMIE L SWANSON

Original Issue Date

03/25/1996

Effective Date

03/25/1996

Expiration Date

09/30/1996

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005