EDWARD E JACKSON Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016002383

License Status

NOT RENEWED

Business

First Name

EDWARD E

Last Name

JACKSON

Business Name

EDWARD E JACKSON

Original Issue Date

08/16/1960

Effective Date

08/16/1960

City

PEKIN

State

Zip

61554

County

TAZEWELL

Ever Disciplined

LastModifiedDate

09/25/2006