STANLEY JACKSON DDS - Dentist License in Illinois | # 019011952

STANLEY JACKSON DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019011952

License Status

NOT RENEWED

Business

N

First Name

STANLEY

Last Name

JACKSON

Suffix

DDS

Business Name

STANLEY JACKSON DDS

Original Issue Date

08/02/1961

Effective Date

08/02/1961

Expiration Date

09/30/1984

State

IL

Ever Disciplined

N

LastModifiedDate

10/12/2005