KYLE WILLIAM JACKSON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056757

License Status

CANCELLED

Business

Title

First Name

KYLE

Middle

WILLIAM

Last Name

JACKSON

Business Name

KYLE WILLIAM JACKSON MD

Original Issue Date

06/23/2009

Effective Date

06/23/2009

Expiration Date

06/22/2012

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

04/13/2009