AMANDA D JORDAN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****69

License Status

NOT RENEWED

Business

First Name

AMANDA

Middle

Last Name

JORDAN

Business Name

AMANDA D JORDAN

Original Issue Date

10/14/2003

Effective Date

10/14/2003

Expiration Date

03/01/2006

City

CHICAGO

State

Zip

60631

County

COOK

Ever Disciplined

LastModifiedDate

09/26/2006