EDWARD MICHAEL JACKSON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001176

License Status

NOT RENEWED

Business

First Name

EDWARD

Middle

MICHAEL

Last Name

JACKSON

Business Name

EDWARD MICHAEL JACKSON

Original Issue Date

06/30/1999

Effective Date

06/30/1999

Expiration Date

06/30/2001

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Pediatric Dentist

Ever Disciplined

LastModifiedDate

07/30/2018