GLENN EDWARD JACKSON DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019010018

License Status

INACTIVE

Business

First Name

GLENN EDWARD

Last Name

JACKSON

Suffix

DDS

Business Name

GLENN EDWARD JACKSON DDS

Original Issue Date

09/26/1951

Effective Date

09/26/1951

Expiration Date

09/30/1994

City

LAKE FOREST

State

Zip

60045

County

LAKE

Ever Disciplined

LastModifiedDate

10/12/2005