JERRY P GIES Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****97

License Status

CANCELLED

Business

First Name

JERRY P

Last Name

GIES

Business Name

JERRY P GIES

Original Issue Date

07/26/1982

Effective Date

06/15/2015

Expiration Date

09/30/2018

City

DAWSON

State

Zip

62520

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/15/2015