JACKSON E FOWLER JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036070326

License Status

NOT RENEWED

Business

First Name

JACKSON E

Last Name

FOWLER JR

Suffix

Business Name

JACKSON E FOWLER JR MD

Original Issue Date

04/15/1985

Effective Date

04/15/1985

Expiration Date

07/31/1993

City

NORTHFIELD

State

Zip

60093

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006