JAMES WILLIAM BLACKBURN DDS - Dentist License in Illinois | # 018001232

JAMES WILLIAM BLACKBURN DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001232

License Status

NOT RENEWED

Business

N

First Name

JAMES

Middle

WILLIAM

Last Name

BLACKBURN

Suffix

DDS

Business Name

JAMES WILLIAM BLACKBURN DDS

Original Issue Date

06/29/2000

Effective Date

06/29/2000

Expiration Date

06/30/2001

State

IL

Specialty/Qualifier

Endodontics

Ever Disciplined

N

LastModifiedDate

10/12/2005