MARTHA A JACKSON Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****92

License Status

NOT RENEWED

Business

First Name

MARTHA A

Last Name

JACKSON

Business Name

MARTHA A JACKSON

Original Issue Date

07/08/1981

Effective Date

07/08/1981

Expiration Date

09/01/1982

City

CHICAGO

State

Zip

60618

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/25/2006