JENNA DORNAK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****45

License Status

NOT RENEWED

Business

First Name

JENNA

Last Name

DORNAK

Business Name

JENNA DORNAK

Original Issue Date

05/22/2019

Effective Date

01/10/2022

Expiration Date

03/01/2024

City

BELLEVILLE

State

Zip

62226

County

SAINT CLAIR

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025