ALBERT LEVERN JACKSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****38

License Status

NOT RENEWED

Business

Title

DDS

First Name

ALBERT

Middle

LEVERN

Last Name

JACKSON

Business Name

ALBERT LEVERN JACKSON DDS

Original Issue Date

01/01/1998

Effective Date

09/28/2009

Expiration Date

09/30/2012

City

CHICAGO

State

Zip

60602

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012