CHRISTINE JACKSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

NOT RENEWED

Business

First Name

CHRISTINE

Last Name

JACKSON

Suffix

Business Name

CHRISTINE JACKSON MD

Original Issue Date

09/01/1994

Effective Date

09/01/1994

Expiration Date

07/31/1996

City

PEORIA

State

Zip

61603

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006