MATTHEW N JACKSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

ACTIVE

Business

Title

First Name

MATTHEW

Middle

Last Name

JACKSON

Business Name

MATTHEW N JACKSON MD

Original Issue Date

09/13/2004

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61612

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2023