JAY IVOR SWANSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****27

License Status

NOT RENEWED

Business

First Name

JAY

Middle

IVOR

Last Name

SWANSON

Suffix

DDS

Business Name

JAY IVOR SWANSON DDS

Original Issue Date

12/05/1994

Effective Date

12/05/1994

Expiration Date

09/30/2000

City

EFFINGHAM

State

Zip

62401

County

EFFINGHAM

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005