EVAN LEIGH JACKSON DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

ACTIVE

Business

Title

First Name

EVAN

Middle

LEIGH

Last Name

JACKSON

Business Name

EVAN LEIGH JACKSON DO

Original Issue Date

03/18/2021

Effective Date

04/24/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/24/2023