RON DARRYL JACKSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****70

License Status

NOT RENEWED

Business

First Name

RON DARRYL

Last Name

JACKSON

Suffix

DDS

Business Name

RON DARRYL JACKSON DDS

Original Issue Date

01/01/1998

Expiration Date

06/01/1982

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005