ERNEST W JACKSON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****19

License Status

NOT RENEWED

Business

First Name

ERNEST W

Last Name

JACKSON

Business Name

ERNEST W JACKSON

Original Issue Date

07/20/1989

Effective Date

07/20/1989

Expiration Date

09/30/1992

City

JEFFERSON CITY

State

Zip

65109

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/06/2016