GLENN EDWARD JACKSON DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021000253

License Status

INACTIVE

Business

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

City

LAKE FOREST

State

Zip

60045

County

LAKE

Specialty/Qualifier

Orthodontics

Ever Disciplined

LastModifiedDate

10/13/2005