EDWARD MICHAEL JACKSON - Dentist License in Illinois | # 018001176

EDWARD MICHAEL JACKSON

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001176

License Status

NOT RENEWED

Business

N

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

State

IL

Specialty/Qualifier

Pediatric Dentist

Ever Disciplined

N

LastModifiedDate

07/30/2018