JACLYN J HAKE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****36

License Status

NOT RENEWED

Business

First Name

JACLYN

Middle

Last Name

HAKE

Business Name

JACLYN J HAKE

Original Issue Date

02/25/2009

Effective Date

01/28/2014

Expiration Date

03/01/2016

City

GILLESPIE

State

Zip

62033

County

MACOUPIN

Ever Disciplined

LastModifiedDate

03/24/2016