LISA CHANEL JACKSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036113699

License Status

ACTIVE

Business

First Name

LISA

Middle

CHANEL

Last Name

JACKSON

Suffix

Business Name

LISA CHANEL JACKSON MD

Original Issue Date

05/16/2005

Effective Date

07/21/2023

Expiration Date

07/31/2026

City

AUGUSTA

State

Zip

30909

County

GEORGIA

Ever Disciplined

LastModifiedDate

04/03/2024