ISAIAH T JERNBERG DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****89

License Status

NOT RENEWED

Business

Title

DDS

First Name

ISAIAH

Middle

Last Name

JERNBERG

Business Name

ISAIAH T JERNBERG DDS

Original Issue Date

07/16/2014

Effective Date

09/11/2015

Expiration Date

09/30/2018

City

PARIS

State

Zip

61944

County

EDGAR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018