JACLYN J HAKE Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003429

License Status

INACTIVE

Business

First Name

JACLYN

Middle

Last Name

HAKE

Business Name

JACLYN J HAKE

Original Issue Date

02/04/2009

Effective Date

01/28/2014

Expiration Date

03/01/2016

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

03/24/2016