JAMES CLARKE JORDAN FAIRFIELD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

NOT RENEWED

Business

Title

First Name

JAMES CLARKE

Middle

JORDAN

Last Name

FAIRFIELD

Business Name

JAMES CLARKE JORDAN FAIRFIELD MD

Original Issue Date

09/10/2012

Effective Date

09/10/2012

Expiration Date

07/31/2014

City

PEORIA

State

Zip

61614

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014