MARILYN DENISE JACKSON DDS - Dentist License in Illinois | # 137000327

MARILYN DENISE JACKSON DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000327

License Status

NOT RENEWED

Business

N

First Name

MARILYN DENISE

Last Name

JACKSON

Suffix

DDS

Business Name

MARILYN DENISE JACKSON DDS

Original Issue Date

10/07/1992

Effective Date

09/21/2015

Expiration Date

09/30/2018

State

IL

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

N

LastModifiedDate

10/31/2018