MITCHELL A JACKSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

ACTIVE

Business

First Name

MITCHELL

Middle

Last Name

JACKSON

Suffix

Business Name

MITCHELL A JACKSON MD

Original Issue Date

10/01/2019

Effective Date

07/01/2023

Expiration Date

07/31/2026

City

LINDENHURST

State

Zip

60046

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/01/2023