MICHELE R JACKSON Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****87

License Status

NOT RENEWED

Business

First Name

MICHELE

Middle

Last Name

JACKSON

Business Name

MICHELE R JACKSON

Original Issue Date

01/19/1999

Effective Date

05/05/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60615

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017