JASON STANWOOD THOMPSON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****71

License Status

NOT RENEWED

Business

First Name

JASON

Middle

STANWOOD

Last Name

THOMPSON

Business Name

JASON STANWOOD THOMPSON

Original Issue Date

02/21/2002

Effective Date

02/21/2002

Expiration Date

09/30/2002

City

ELGIN

State

Zip

60120

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005