GLENN EDWARD JACKSON DDS - Dentist License in Illinois | # 021000253

GLENN EDWARD JACKSON DDS

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021000253

License Status

INACTIVE

Business

N

First Name

GLENN EDWARD

Last Name

JACKSON

Suffix

DDS

Business Name

GLENN EDWARD JACKSON DDS

Original Issue Date

01/16/1957

Effective Date

01/16/1957

Expiration Date

09/30/1994

State

IL

Specialty/Qualifier

Orthodontics

Ever Disciplined

N

LastModifiedDate

10/13/2005