LISA N JACKSON Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036115380

License Status

INACTIVE

Business

First Name

LISA

Middle

Last Name

JACKSON

Business Name

LISA N JACKSON

Original Issue Date

03/14/2006

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

NEW YORK

State

Zip

10128

Ever Disciplined

LastModifiedDate

04/17/2008