JENNIFER LEIGH PETTIT DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****24

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

LEIGH

Last Name

PETTIT

Suffix

DDS

Business Name

JENNIFER LEIGH PETTIT DDS

Original Issue Date

03/08/2006

Effective Date

06/16/2009

Expiration Date

09/30/2012

City

GRAYSLAKE

State

Zip

60030

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012