JAMIE KATHLEEN MOSS DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****49

License Status

NOT RENEWED

Business

First Name

JAMIE

Middle

KATHLEEN

Last Name

MOSS

Suffix

DDS

Business Name

JAMIE KATHLEEN MOSS DDS

Original Issue Date

09/15/2008

Effective Date

07/30/2009

Expiration Date

09/30/2012

City

WHEATON

State

Zip

60187

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012