PHILIP LARKIN JACKSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****67

License Status

ACTIVE

Business

Title

First Name

PHILIP

Middle

LARKIN

Last Name

JACKSON

Business Name

PHILIP LARKIN JACKSON MD

Original Issue Date

04/29/2019

Effective Date

07/24/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/24/2023