License Directory

Edgar Basil Jackson Md

Expired

Illinois license 036053100

License

Licensed by
Illinois Department of Financial and Professional Regulation
License number
036053100
Status
Expired (Not Renewed)
First issued
July 15, 1976
Expired
July 31, 2017
License holder
Edgar Basil Jackson Md
Entity type
Individual

Classifications

More from the license record

Current term began
04/29/2014

Contact

Menomonee Falls, WI 53051
Wisconsin County