SHELLY AMANDA BEDAYSE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****98

License Status

NOT RENEWED

Business

First Name

SHELLY

Middle

AMANDA

Last Name

BEDAYSE

Business Name

SHELLY AMANDA BEDAYSE

Original Issue Date

07/29/2015

Effective Date

07/29/2015

Expiration Date

09/30/2018

City

CREST HILL

State

Zip

60403

County

WILL

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

10/31/2018