ALYCE F JACKSON Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****98

License Status

NOT RENEWED

Business

First Name

ALYCE F

Last Name

JACKSON

Business Name

ALYCE F JACKSON

Original Issue Date

05/07/1997

Effective Date

05/15/2020

Expiration Date

07/31/2023

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023