SANDRA N JACKSON DENT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

NOT RENEWED

Business

Title

First Name

SANDRA

Middle

Last Name

JACKSON DENT

Business Name

SANDRA N JACKSON DENT MD

Original Issue Date

04/20/2012

Effective Date

06/16/2017

Expiration Date

09/30/2020

City

LAWRENCEVILLE

State

Zip

30045

County

GEORGIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021