DEBRA K JACKSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

NOT RENEWED

Business

Title

First Name

DEBRA K

Last Name

JACKSON

Business Name

DEBRA K JACKSON MD

Original Issue Date

04/08/1996

Effective Date

04/08/1996

Expiration Date

07/31/2008

City

MOUNT ZION

State

Zip

62549

County

MACON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020