MARILYN DENISE JACKSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****54

License Status

NOT RENEWED

Business

First Name

MARILYN DENISE

Last Name

JACKSON

Suffix

DDS

Business Name

MARILYN DENISE JACKSON DDS

Original Issue Date

08/29/1988

Effective Date

09/21/2015

Expiration Date

09/30/2018

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018