JACK ALVIN SHANNON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019013454

License Status

NOT RENEWED

Business

First Name

JACK ALVIN

Last Name

SHANNON

Suffix

DDS

Business Name

JACK ALVIN SHANNON DDS

Original Issue Date

07/16/1968

Effective Date

07/16/1968

Expiration Date

09/30/2004

City

COWETA

State

Zip

74429

County

OKLAHOMA

Ever Disciplined

LastModifiedDate

10/17/2005