JACOB I JACKSON DO Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036145203

License Status

INACTIVE

Business

Title

First Name

JACOB

Middle

Last Name

JACKSON

Business Name

JACOB I JACKSON DO

Original Issue Date

02/27/2018

Effective Date

02/27/2018

Expiration Date

09/30/2020

City

VALLEY PARK

State

Zip

63088

Ever Disciplined

LastModifiedDate

04/05/2020