LISA CHANEL JACKSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****29

License Status

ACTIVE

Business

First Name

LISA

Middle

CHANEL

Last Name

JACKSON

Suffix

Business Name

LISA CHANEL JACKSON MD

Original Issue Date

01/11/2024

Effective Date

01/11/2024

Expiration Date

07/31/2026

City

AUGUSTA

State

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/12/2024