STEPHEN HOLT JACKSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****97

License Status

NOT RENEWED

Business

First Name

STEPHEN HOLT

Last Name

JACKSON

Suffix

Business Name

STEPHEN HOLT JACKSON MD

Original Issue Date

12/15/1982

Effective Date

09/18/2020

Expiration Date

07/31/2023

City

METROPOLIS

State

Zip

62960

County

MASSAC

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023