JASON PETER DYKSTRA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

ACTIVE

Business

Title

First Name

JASON

Middle

PETER

Last Name

DYKSTRA

Business Name

JASON PETER DYKSTRA MD

Original Issue Date

09/10/2024

Effective Date

09/10/2024

Expiration Date

07/31/2026

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/10/2024