JEFFREY K JACKSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

NOT RENEWED

Business

First Name

JEFFREY

Middle

Last Name

JACKSON

Suffix

Business Name

JEFFREY K JACKSON MD

Original Issue Date

05/03/2016

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

SWANSEA

State

Zip

62226

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021