SAMUEL WESLEY JACKSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036169934

License Status

ACTIVE

Business

Title

First Name

SAMUEL

Middle

WESLEY

Last Name

JACKSON

Business Name

SAMUEL WESLEY JACKSON MD

Original Issue Date

04/19/2024

Effective Date

04/19/2024

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60622

County

COOK

Ever Disciplined

LastModifiedDate

07/23/2024