DANA MARVELLE JACKSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019025879

License Status

NOT RENEWED

Business

First Name

DANA

Middle

MARVELLE

Last Name

JACKSON

Suffix

DDS

Business Name

DANA MARVELLE JACKSON DDS

Original Issue Date

06/14/2002

Effective Date

12/10/2012

Expiration Date

09/30/2015

City

SHREVEPORT

State

Zip

71105

County

LOUISIANA

Ever Disciplined

LastModifiedDate

02/08/2016