AMANDA SUE JACKSON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045130

License Status

EXPIRED

Business

First Name

AMANDA

Middle

SUE

Last Name

JACKSON

Suffix

Business Name

AMANDA SUE JACKSON MD

Original Issue Date

06/24/2002

Effective Date

06/24/2002

Expiration Date

06/23/2005

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006