JACOB EDWARD COFFEY Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****87

License Status

ACTIVE

Business

First Name

JACOB

Middle

EDWARD

Last Name

COFFEY

Business Name

JACOB EDWARD COFFEY

Original Issue Date

02/20/2018

Effective Date

09/27/2024

Expiration Date

09/30/2027

City

SPRINGFIELD

State

Zip

62707

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/27/2024