RODGER DALE JACKSON JR DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036141602

License Status

NOT RENEWED

Business

Title

First Name

RODGER

Middle

DALE

Last Name

JACKSON

Suffix

Business Name

RODGER DALE JACKSON JR DO

Original Issue Date

08/29/2016

Effective Date

05/30/2017

Expiration Date

09/30/2020

City

MACOMB

State

Zip

48044

County

MICHIGAN

Ever Disciplined

LastModifiedDate

01/14/2021