JACQUELINE JORDAN SPIEGEL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****38

License Status

NOT RENEWED

Business

First Name

JACQUELINE

Middle

JORDAN

Last Name

SPIEGEL

Business Name

JACQUELINE JORDAN SPIEGEL

Original Issue Date

01/10/2002

Effective Date

01/10/2002

Expiration Date

03/01/2006

City

ROUND LAKE

State

Zip

60073

County

LAKE

Ever Disciplined

LastModifiedDate

10/31/2007