CRYSTAL LYNN JACKSON PA-C Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001131

License Status

NOT RENEWED

Business

First Name

CRYSTAL

Middle

LYNN

Last Name

JACKSON

Suffix

PA-C

Business Name

CRYSTAL LYNN JACKSON PA-C

Original Issue Date

01/11/1999

Effective Date

01/11/1999

Expiration Date

03/01/2000

City

CHICAGO

State

Zip

60656

County

COOK

Ever Disciplined

LastModifiedDate

09/26/2006