JAIME M POULOS DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019026797

License Status

NOT RENEWED

Business

First Name

JAIME

Middle

Last Name

POULOS

Suffix

DDS

Business Name

JAIME M POULOS DDS

Original Issue Date

06/27/2005

Effective Date

08/28/2009

Expiration Date

09/30/2012

City

NORTHPORT

State

Zip

11768

County

NEW YORK

Ever Disciplined

LastModifiedDate

11/14/2012