JESS W MIKESELL Dentist License verification

Business Entity

INOPERATIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****68

License Status

INOPERATIVE

Business

First Name

JESS W

Last Name

MIKESELL

Business Name

JESS W MIKESELL

Original Issue Date

09/12/1985

Effective Date

07/16/2024

Expiration Date

09/30/2027

City

CENTRALIA

State

Zip

62801

County

MARION

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/16/2024