JORDAN FRANK FLEISHHACKER MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

CANCELLED

Business

First Name

JORDAN

Middle

FRANK

Last Name

FLEISHHACKER

Suffix

Business Name

JORDAN FRANK FLEISHHACKER MD

Original Issue Date

12/16/2004

Effective Date

12/16/2004

Expiration Date

07/31/2005

City

PITTSFIELD

State

Zip

62363

County

PIKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006