JASON MICHAEL MAILHOT DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021002384

License Status

NOT RENEWED

Business

Title

DMD

First Name

JASON

Middle

MICHAEL

Last Name

MAILHOT

Business Name

JASON MICHAEL MAILHOT DMD

Original Issue Date

08/19/2010

Effective Date

08/19/2010

Expiration Date

09/30/2012

City

HAMPTON

State

Zip

61256

County

ROCK ISLAND

Specialty/Qualifier

PERIODONTICS

Ever Disciplined

LastModifiedDate

11/14/2012