TIPHANY DEE JACKSON JOHNSON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068801

License Status

CANCELLED

Business

Title

First Name

TIPHANY

Middle

DEE

Last Name

JACKSON JOHNSON

Business Name

TIPHANY DEE JACKSON JOHNSON MD

Original Issue Date

07/08/2019

Effective Date

07/08/2019

Expiration Date

06/30/2020

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Obstetrics and Gynecology

Ever Disciplined

LastModifiedDate

07/08/2019