MATTHEW N JACKSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

ACTIVE

Business

Title

First Name

MATTHEW

Middle

Last Name

JACKSON

Business Name

MATTHEW N JACKSON MD

Original Issue Date

10/06/2017

Effective Date

04/12/2023

Expiration Date

07/31/2026

City

IPAVA

State

Zip

61441

County

TAZEWELL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2023