CHRISTIAN S JACKSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

NOT RENEWED

Business

First Name

CHRISTIAN

Middle

Last Name

JACKSON

Suffix

Business Name

CHRISTIAN S JACKSON MD

Original Issue Date

07/12/2002

Effective Date

07/12/2002

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011