BRANDI ROCHELLE JACKSON - Dentist License in Illinois | # 018001602

BRANDI ROCHELLE JACKSON

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001602

License Status

EXPIRED

Business

N

First Name

BRANDI

Middle

ROCHELLE

Last Name

JACKSON

Business Name

BRANDI ROCHELLE JACKSON

Original Issue Date

07/21/2006

Effective Date

07/21/2006

Expiration Date

06/30/2008

State

IL

Specialty/Qualifier

Pediatric Dentist

Ever Disciplined

N

LastModifiedDate

07/30/2018