JARED P ISOM DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****59

License Status

NOT RENEWED

Business

First Name

JARED

Middle

Last Name

ISOM

Suffix

DDS

Business Name

JARED P ISOM DDS

Original Issue Date

01/01/1998

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

MILLSTADT

State

Zip

62260

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009