JACKSON LAVALE GATES MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036165299

License Status

ACTIVE

Business

Title

First Name

JACKSON

Middle

LAVALE

Last Name

GATES

Business Name

JACKSON LAVALE GATES MD

Original Issue Date

06/20/2023

Effective Date

06/20/2023

Expiration Date

07/31/2026

City

CONYERS

State

Zip

30013

Ever Disciplined

LastModifiedDate

06/20/2023