Edgar Basil Jackson Md
ExpiredIllinois 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
- Licensed Physician and Surgeon (Medical Board) Physicians & Surgeons
More from the license record
- Current term began
- 04/29/2014
Contact
Menomonee Falls, WI 53051
Wisconsin County