CYNTHIA R JACKSON DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036094720

License Status

NOT RENEWED

Business

First Name

CYNTHIA R

Last Name

JACKSON

Suffix

Business Name

CYNTHIA R JACKSON DO

Original Issue Date

01/27/1997

Effective Date

01/27/1997

Expiration Date

07/31/2002

City

PEORIA

State

Zip

61637

County

PEORIA

Ever Disciplined

LastModifiedDate

10/09/2006