JEFFREY WILLIAM LEWIS DENT Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002003

License Status

NOT RENEWED

Business

First Name

JEFFREY WILLIAM

Middle

LEWIS

Last Name

DENT

Business Name

JEFFREY WILLIAM LEWIS DENT

Original Issue Date

04/22/2003

Effective Date

04/22/2003

Expiration Date

03/01/2004

City

MOUNT PROSPECT

State

Zip

60056

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006