JACK DAVID ANDERSON IDPR Registered License verification

Business Entity

NOT RENEWED

License Type

IDPR Registered

Description

CERTIFIED EUTHANASIA TECHNICIAN

License Number

235000047

License Status

NOT RENEWED

Business

First Name

JACK

Middle

DAVID

Last Name

ANDERSON

Business Name

JACK DAVID ANDERSON

Original Issue Date

09/20/2005

Effective Date

04/18/2006

Expiration Date

04/30/2008

City

KEWANEE

State

Zip

61443

County

HENRY

Ever Disciplined

LastModifiedDate

06/04/2008