LISA N JACKSON Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****46

License Status

CANCELLED

Business

First Name

LISA

Middle

Last Name

JACKSON

Business Name

LISA N JACKSON

Original Issue Date

03/16/2006

Effective Date

03/16/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60605

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2008