JAY A PATEL DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****74

License Status

NOT RENEWED

Business

First Name

JAY A

Last Name

PATEL

Suffix

DDS

Business Name

JAY A PATEL DDS

Original Issue Date

09/15/1995

Effective Date

09/15/1995

Expiration Date

09/30/1998

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005