LESLIE K JACKSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****27

License Status

NOT RENEWED

Business

First Name

LESLIE K

Last Name

JACKSON

Suffix

Business Name

LESLIE K JACKSON MD

Original Issue Date

06/12/1987

Effective Date

06/12/1987

Expiration Date

07/31/1999

City

ASSUMPTION

State

Zip

62510

County

CHRISTIAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011