GREGORY D JACKSON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****80

License Status

NOT RENEWED

Business

First Name

GREGORY

Middle

Last Name

JACKSON

Suffix

Business Name

GREGORY D JACKSON OD

Original Issue Date

05/07/1996

Effective Date

03/03/2020

Expiration Date

05/31/2022

City

BATAVIA

State

Zip

60510

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

07/27/2022