License holder summary

Frederic Leslie Jackson is a Controlled Substance Registration-Osteopathic Physician licensed to practice in Indiana. The address on file for Frederic Leslie Jackson is FORT WAYNE MEDICAL EDUCATION PROGRAM, 2434 LAKE AVENUE, FORT WAYNE IN 46805. This licensed professional license is not current. The license was granted 09/29/1995 and expired on 06/30/2005.

Indiana

Professional Licensing Agency

Frederic Leslie Jackson
Controlled Substance Registration-Osteopathic Physician
License number
02001678B
Date granted
09/29/1995
Date expires
06/30/2005
Class
Controlled Substance Registration-Osteopathic Physician
Status
Expired
Address
FORT WAYNE MEDICAL EDUCATION PROGRAM, 2434 LAKE AVENUE, FORT WAYNE IN 46805
indianalicensing.org
ID 5800447
LAST UPDATED 2024-03-06 20:00:14 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

Reviews

Are you familiar with Frederic Leslie Jackson's work? Add a comment below. You can write anonymously and without having to create an account.

Similar names
Trending