STEPHANIE JANE JACKSON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053014

License Status

EXPIRED

Business

First Name

STEPHANIE

Middle

JANE

Last Name

JACKSON

Suffix

Business Name

STEPHANIE JANE JACKSON MD

Original Issue Date

07/01/2007

Effective Date

07/01/2007

Expiration Date

06/30/2010

City

CHICAGO

State

Zip

60608

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

07/08/2010