ROBERT WAYNE JACKSON DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****25

License Status

NOT RENEWED

Business

Title

First Name

ROBERT

Middle

WAYNE

Last Name

JACKSON

Business Name

ROBERT WAYNE JACKSON DO

Original Issue Date

12/05/2017

Effective Date

12/05/2017

Expiration Date

09/30/2020

City

SCHAUMBURG

State

Zip

60173

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021