Wynn K Jackson Md Controlled Substance Registration for Practitioner
2 Benedict Place, Greenwich, CT 06830


Wynn K Jackson Md is licensed in the eLicensing system of Connecticut. The license credential ID is 159663. The license type is CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER. The license status is ACTIVE. The address is 2 Benedict Place, Greenwich, CT 06830. The zip code is 06830.


Wynn K Jackson Md · 2 Benedict Place, Greenwich, CT 06830

Credential ID 159663
Name WYNN K JACKSON MD
Type INDIVIDUAL
Address 2 BENEDICT PLACE
GREENWICH, CT 06830
License Credential CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Full Credential Code CSP.0018311
Credential Type CSP
Credential Number 18311
Status ACTIVE
Status Reason CURRENT
Active 1
Issue Date 03/01/2003
Effective Date 03/01/2015
Expiration Date 02/28/2017
Record Refresh Date 02/26/201

Zip 06830 · Controlled Substance Registration for Practitioner · Connecticut Business

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