MICHAELIS BILLY JACKSON Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

NOT RENEWED

Business

First Name

MICHAELIS BILLY

Last Name

JACKSON

Business Name

MICHAELIS BILLY JACKSON

Original Issue Date

10/07/1991

Effective Date

06/26/2017

Expiration Date

09/30/2020

City

HERRIN

State

Zip

62948

County

WILLIAMSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021