MARISA D JACKSON Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125025263

License Status

EXPIRED

Business

First Name

MARISA

Middle

Last Name

JACKSON

Business Name

MARISA D JACKSON

Original Issue Date

05/30/1990

Effective Date

05/30/1990

Expiration Date

06/30/1996

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006