JAY RAM SHETTY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****54

License Status

NOT RENEWED

Business

First Name

JAY RAM

Last Name

SHETTY

Business Name

JAY RAM SHETTY

Original Issue Date

09/29/1989

Effective Date

09/29/1989

Expiration Date

09/30/1992

City

HANNA CITY

State

Zip

61536

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005