JENNIFER W SHAW Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****81

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

Last Name

SHAW

Business Name

JENNIFER W SHAW

Original Issue Date

10/17/2001

Effective Date

07/27/2009

Expiration Date

09/30/2012

City

WHEELING

State

Zip

60090

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012