JORDAN RIVETT Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****06

License Status

NOT RENEWED

Business

First Name

JORDAN

Last Name

RIVETT

Business Name

JORDAN RIVETT

Original Issue Date

02/19/2020

Effective Date

02/19/2020

Expiration Date

03/01/2022

City

PERU

State

Zip

61354

County

LA SALLE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022