JACK EDWARD JORDAN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019013374

License Status

NOT RENEWED

Business

First Name

JACK EDWARD

Last Name

JORDAN

Suffix

DMD

Business Name

JACK EDWARD JORDAN DMD

Original Issue Date

07/16/1968

Effective Date

07/16/1968

Expiration Date

09/30/1998

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/12/2005