JAY K PATEL DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****70

License Status

NOT RENEWED

Business

Title

DMD

First Name

JAY

Middle

Last Name

PATEL

Business Name

JAY K PATEL DMD

Original Issue Date

12/01/2009

Effective Date

08/15/2012

Expiration Date

09/30/2015

City

CHICAGO

State

Zip

60642

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016