JACK IAN MAYER DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019024734

License Status

NOT RENEWED

Business

First Name

JACK

Middle

IAN

Last Name

MAYER

Suffix

DMD

Business Name

JACK IAN MAYER DMD

Original Issue Date

06/23/1998

Effective Date

06/23/1998

Expiration Date

09/30/1998

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

10/12/2005