TIMOTHY JOSEPH JACKSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****45

License Status

NOT RENEWED

Business

Title

First Name

TIMOTHY

Middle

JOSEPH

Last Name

JACKSON

Business Name

TIMOTHY JOSEPH JACKSON MD

Original Issue Date

05/24/2012

Effective Date

05/24/2012

Expiration Date

07/31/2014

City

WESTMONT

State

Zip

60559

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014