JAY IVOR SWANSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****25

License Status

NOT RENEWED

Business

First Name

JAY

Middle

IVOR

Last Name

SWANSON

Suffix

DDS

Business Name

JAY IVOR SWANSON DDS

Original Issue Date

08/09/1989

Effective Date

08/09/1989

Expiration Date

09/30/1992

City

ELMHURST

State

Zip

60126

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005