JESS FOWLER HAVRON DMD - Dentist License in Illinois | # 136000147

JESS FOWLER HAVRON DMD

Business Entity

EXPIRED

License Type

Dentist

Description

RESTRICTED FACULTY LICENSE

License Number

136000147

License Status

EXPIRED

Business

N

First Name

JESS

Middle

FOWLER

Last Name

HAVRON

Suffix

DMD

Business Name

JESS FOWLER HAVRON DMD

Original Issue Date

03/31/2010

Effective Date

07/01/2010

Expiration Date

06/30/2012

State

IL

Ever Disciplined

N

LastModifiedDate

08/29/2012