LEODINE JACKSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036047622

License Status

NOT RENEWED

Business

First Name

LEODINE

Last Name

JACKSON

Suffix

Business Name

LEODINE JACKSON MD

Original Issue Date

08/02/1973

Effective Date

08/02/1973

City

DECATUR

State

Zip

62521

County

MACON

Ever Disciplined

LastModifiedDate

09/20/2006