MILES WILLIAM JACKSON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130001252

License Status

EXPIRED

Business

Title

First Name

MILES

Middle

WILLIAM

Last Name

JACKSON

Business Name

MILES WILLIAM JACKSON MD

Original Issue Date

09/01/2018

Effective Date

09/01/2018

Expiration Date

09/30/2018

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Vascular Surgery

Ever Disciplined

LastModifiedDate

12/04/2018