WYETH JESS JORDAN DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****39

License Status

ACTIVE

Business

Title

First Name

WYETH

Middle

JESS

Last Name

JORDAN

Business Name

WYETH JESS JORDAN DO

Original Issue Date

03/04/2014

Effective Date

07/11/2023

Expiration Date

07/31/2026

City

BARRINGTON

State

Zip

60010

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/11/2023