JORDAN RIVETT Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007493

License Status

NOT RENEWED

Business

First Name

JORDAN

Last Name

RIVETT

Business Name

JORDAN RIVETT

Original Issue Date

01/15/2020

Effective Date

01/15/2020

Expiration Date

03/01/2022

City

PERU

State

Zip

61354

County

LA SALLE

Ever Disciplined

LastModifiedDate

07/27/2022