JACK RICHARD MASON - Dentist License in Illinois | # 021000294

JACK RICHARD MASON

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021000294

License Status

NOT RENEWED

Business

N

First Name

JACK RICHARD

Last Name

MASON

Business Name

JACK RICHARD MASON

Original Issue Date

12/24/1959

Effective Date

12/24/1959

Expiration Date

09/30/1988

State

IL

Specialty/Qualifier

Orthodontics

Ever Disciplined

N

LastModifiedDate

10/13/2005