GLORIA JACKSON BACON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****49

License Status

NOT RENEWED

Business

First Name

GLORIA JACKSON

Last Name

BACON

Suffix

Business Name

GLORIA JACKSON BACON MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60615

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011