WILLIE MAE JACKSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

ACTIVE

Business

Title

First Name

WILLIE

Middle

MAE

Last Name

JACKSON

Business Name

WILLIE MAE JACKSON MD

Original Issue Date

07/17/2014

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

OAK PARK

State

Zip

60304

County

LOGAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/16/2025