ROOSEVELT T JACKSON JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036063503

License Status

NOT RENEWED

Business

First Name

ROOSEVELT T

Last Name

JACKSON JR

Suffix

Business Name

ROOSEVELT T JACKSON JR MD

Original Issue Date

10/29/1981

Effective Date

10/29/1981

Expiration Date

07/31/1987

City

CHICAGO

State

Zip

60615

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006