JAY RAM SHETTY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****52

License Status

NOT RENEWED

Business

First Name

JAY RAM

Last Name

SHETTY

Business Name

JAY RAM SHETTY

Original Issue Date

01/01/1998

Expiration Date

09/30/2004

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005