JERRY THOMAS WASHBURN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****72

License Status

NOT RENEWED

Business

First Name

JERRY THOMAS

Last Name

WASHBURN

Suffix

DDS

Business Name

JERRY THOMAS WASHBURN DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/1992

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Controlled Substance Schedule

II III

Ever Disciplined

LastModifiedDate

10/13/2005