DENNIS JACKSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

ACTIVE

Business

Title

First Name

DENNIS

Last Name

JACKSON

Business Name

DENNIS JACKSON MD

Original Issue Date

10/07/2024

Effective Date

10/07/2024

Expiration Date

07/31/2026

City

BREESE

State

Zip

62230

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/07/2024