JORDYN A DRAKE DO

Business Entity
ACTIVE

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****84

ACTIVE

N

DO

JORDYN

A

DRAKE

JORDYN A DRAKE DO

08/01/2024

08/01/2024

07/31/2026

CARBONDALE

IL

62901

JACKSON

PRACTITIONER

II III IV V

N

08/01/2024