JACK EDWARD JORDAN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021000663

License Status

NOT RENEWED

Business

First Name

JACK EDWARD

Last Name

JORDAN

Suffix

DMD

Business Name

JACK EDWARD JORDAN DMD

Original Issue Date

12/07/1970

Effective Date

12/07/1970

Expiration Date

09/30/1998

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Specialty/Qualifier

Oral and Maxillofacial Surgery

Ever Disciplined

LastModifiedDate

10/13/2005