LESLIE K JACKSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

NOT RENEWED

Business

First Name

LESLIE K

Last Name

JACKSON

Suffix

Business Name

LESLIE K JACKSON MD

Original Issue Date

07/09/1987

Effective Date

07/09/1987

Expiration Date

07/31/1990

City

MORRISONVILLE

State

Zip

62546

County

CHRISTIAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011