RICHARD THOMAS CLEARY JACKSON Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

ACTIVE

Business

First Name

RICHARD

Middle

THOMAS CLEARY

Last Name

JACKSON

Business Name

RICHARD THOMAS CLEARY JACKSON

Original Issue Date

08/05/2020

Effective Date

06/14/2023

Expiration Date

07/31/2026

City

NEWPORT NEWS

State

Zip

23601

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/14/2023