JOHN WILLIAM JACKSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

NOT RENEWED

Business

First Name

JOHN WILLIAM

Last Name

JACKSON

Suffix

Business Name

JOHN WILLIAM JACKSON MD

Original Issue Date

01/01/1997

Effective Date

05/28/2008

Expiration Date

07/31/2011

City

EAST ST LOUIS

State

Zip

62201

County

SAINT CLAIR

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

04/11/2017