KAYA INDIGO JACKSON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059867

License Status

CANCELLED

Business

Title

First Name

KAYA

Middle

INDIGO

Last Name

JACKSON

Business Name

KAYA INDIGO JACKSON MD

Original Issue Date

06/26/2014

Effective Date

06/26/2014

Expiration Date

06/25/2017

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

05/13/2014