FRED JEROME JAECKEL Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019009470

License Status

NOT RENEWED

Business

First Name

FRED JEROME

Last Name

JAECKEL

Business Name

FRED JEROME JAECKEL

Original Issue Date

08/11/1948

Effective Date

09/30/2004

Expiration Date

09/30/2006

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

07/19/2007