BENNETT H JACOBY - Dentist License in Illinois | # 018000208

BENNETT H JACOBY

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000208

License Status

NOT RENEWED

Business

N

First Name

BENNETT

Middle

H

Last Name

JACOBY

Business Name

BENNETT H JACOBY

Original Issue Date

09/11/1987

Effective Date

09/11/1987

Expiration Date

07/01/1989

State

IL

Specialty/Qualifier

Oral and Maxillofacial Surgery

Ever Disciplined

N

LastModifiedDate

10/12/2005