JACK L LARSON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019008643

License Status

NOT RENEWED

Business

First Name

JACK L

Last Name

LARSON

Business Name

JACK L LARSON

Original Issue Date

06/05/1944

Effective Date

06/05/1944

Expiration Date

09/30/2002

City

CHICAGO

State

Zip

60617

County

COOK

Ever Disciplined

LastModifiedDate

10/17/2005

Case Number

1986000899

Action

Suspension

Discipline Start Date

05/31/1986

Discipline End Date

06/20/1986