JORDAN LAYNE JACKSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005249

License Status

NOT RENEWED

Business

First Name

JORDAN

Middle

LAYNE

Last Name

JACKSON

Business Name

JORDAN LAYNE JACKSON

Original Issue Date

09/23/2014

Effective Date

02/23/2016

Expiration Date

03/01/2018

City

TINLEY PARK

State

Zip

60477

County

COOK

Ever Disciplined

LastModifiedDate

05/10/2018