JORDYN A DRAKE DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125077767

License Status

CANCELLED

Business

Title

First Name

JORDYN

Middle

Last Name

DRAKE

Business Name

JORDYN A DRAKE DO

Original Issue Date

07/01/2021

Effective Date

07/01/2021

Expiration Date

06/30/2024

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

10/25/2024