JAY VINCENT LEWIS DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****44

License Status

NOT RENEWED

Business

First Name

JAY VINCENT

Last Name

LEWIS

Suffix

DDS

Business Name

JAY VINCENT LEWIS DDS

Original Issue Date

01/01/1998

Expiration Date

06/01/1982

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005