JEAN MARTIAL CORRIVEAU DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****77

License Status

NOT RENEWED

Business

First Name

JEAN MARTIAL

Last Name

CORRIVEAU

Suffix

DDS

Business Name

JEAN MARTIAL CORRIVEAU DDS

Original Issue Date

01/01/1998

Effective Date

08/20/2009

Expiration Date

09/30/2012

City

CHATHAM

State

Zip

62629

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012