MARY L 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

First Name

MARY

Middle

Last Name

JACKSON

Suffix

Business Name

MARY L JACKSON MD

Original Issue Date

09/15/1982

Effective Date

09/03/2020

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60619

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023