SHELBY ELLIS JACKSON Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021003305

License Status

ACTIVE

Business

First Name

SHELBY

Middle

ELLIS

Last Name

JACKSON

Business Name

SHELBY ELLIS JACKSON

Original Issue Date

12/28/2023

Effective Date

09/05/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS

Ever Disciplined

LastModifiedDate

09/05/2024