DANIELLE S JACKSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036146152

License Status

NOT RENEWED

Business

Title

First Name

DANIELLE

Middle

Last Name

JACKSON

Business Name

DANIELLE S JACKSON MD

Original Issue Date

05/15/2018

Effective Date

05/15/2018

Expiration Date

09/30/2020

City

NEW HAVEN

State

Zip

06511

Ever Disciplined

LastModifiedDate

01/14/2021