TARA ANNE JACKSON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042271

License Status

EXPIRED

Business

First Name

TARA

Middle

ANNE

Last Name

JACKSON

Suffix

Business Name

TARA ANNE JACKSON MD

Original Issue Date

06/18/2001

Effective Date

06/18/2001

Expiration Date

06/17/2004

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006