JOHN WILLIAM JACKSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

NOT RENEWED

Business

First Name

JOHN WILLIAM

Last Name

JACKSON

Suffix

Business Name

JOHN WILLIAM JACKSON MD

Original Issue Date

08/05/1993

Effective Date

08/05/1993

Expiration Date

07/31/1996

City

PEORIA

State

Zip

61603

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006