MARVIN WILLIAM JACKSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

NOT RENEWED

Business

Title

First Name

MARVIN

Middle

WILLIAM

Last Name

JACKSON

Business Name

MARVIN WILLIAM JACKSON MD

Original Issue Date

02/09/2009

Effective Date

07/13/2017

Expiration Date

09/30/2020

City

DES PLAINES

State

Zip

60018

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021