THEODORE MICHAEL JACKSON DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019026503

License Status

ACTIVE

Business

First Name

THEODORE

Middle

MICHAEL

Last Name

JACKSON

Suffix

DMD

Business Name

THEODORE MICHAEL JACKSON DMD

Original Issue Date

07/01/2004

Effective Date

08/26/2024

Expiration Date

09/30/2027

City

COLUMBUS

State

Zip

43201

Ever Disciplined

LastModifiedDate

08/26/2024