DIANE KAY JACKMAN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020003374

License Status

NOT RENEWED

Business

First Name

DIANE KAY

Last Name

JACKMAN

Business Name

DIANE KAY JACKMAN

Original Issue Date

09/29/1977

Effective Date

09/28/2015

Expiration Date

09/30/2018

City

PEKIN

State

Zip

61554

County

TAZEWELL

Ever Disciplined

LastModifiedDate

10/31/2018