JAY HOWARD BLACKBURN DDS - Dentist License in Illinois | # 019017021

JAY HOWARD BLACKBURN DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019017021

License Status

NOT RENEWED

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

10/12/2005