JAY RAM SHETTY Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****53

License Status

CANCELLED

Business

First Name

JAY RAM

Last Name

SHETTY

Business Name

JAY RAM SHETTY

Original Issue Date

08/31/1989

Effective Date

08/31/1989

Expiration Date

09/30/1992

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005