JAY HOWARD BLACKBURN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019017021

License Status

NOT RENEWED

Business

First Name

JAY HOWARD

Last Name

BLACKBURN

Suffix

DDS

Business Name

JAY HOWARD BLACKBURN DDS

Original Issue Date

11/21/1979

Effective Date

11/21/1979

Expiration Date

09/30/1992

City

CALUMET CITY

State

Zip

60409

County

COOK

Ever Disciplined

LastModifiedDate

10/12/2005