JULIE ANNE JACKSON Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****16

License Status

NOT RENEWED

Business

First Name

JULIE

Middle

ANNE

Last Name

JACKSON

Business Name

JULIE ANNE JACKSON

Original Issue Date

05/03/2011

Effective Date

05/03/2011

Expiration Date

07/31/2014

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2017