STEPHANIE RUTH JACK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020016543

License Status

NOT RENEWED

Business

First Name

STEPHANIE

Middle

RUTH

Last Name

JACK

Business Name

STEPHANIE RUTH JACK

Original Issue Date

07/20/2019

Effective Date

07/20/2019

Expiration Date

01/31/2022

City

STRASBURG

State

Zip

62465

County

SHELBY

Ever Disciplined

LastModifiedDate

05/09/2022

Case Number

2021011664

Action

Suspension

Discipline Start Date

02/28/2022

Discipline End Date

03/27/2024

Discipline Reason

Failure to file and/or pay Illinois state income taxes. Notice of tax deficiency release received from Department of Revenue on 03/28/2024.