LESLIE K JACKSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036072876

License Status

NOT RENEWED

Business

First Name

LESLIE K

Last Name

JACKSON

Suffix

Business Name

LESLIE K JACKSON MD

Original Issue Date

06/12/1986

Effective Date

07/13/2011

Expiration Date

07/31/2014

City

TAYLORVILLE

State

Zip

62568

County

CHRISTIAN

Ever Disciplined

LastModifiedDate

09/06/2019

Case Number

2012011719

Action

Refuse To Renew

Discipline Start Date

08/22/2019

Discipline Reason

due to failure to comply with the terms and conditions of August 13 Consent Order.