CAROL D JACKSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****79

License Status

NOT RENEWED

Business

First Name

CAROL

Middle

Last Name

JACKSON

Suffix

DDS

Business Name

CAROL D JACKSON DDS

Original Issue Date

03/23/1993

Effective Date

08/11/2015

Expiration Date

09/30/2018

City

JACKSONVILLE

State

Zip

62650

County

MORGAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018