ERIC RAYMOND JACKSON MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

INACTIVE

Business

Title

First Name

ERIC

Middle

RAYMOND

Last Name

JACKSON

Business Name

ERIC RAYMOND JACKSON MD

Original Issue Date

02/07/2019

Effective Date

05/27/2020

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60642

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/27/2020