JODI ALISE MARTIN Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****91

License Status

INOPERATIVE

Business

First Name

JODI

Middle

ALISE

Last Name

MARTIN

Business Name

JODI ALISE MARTIN

Original Issue Date

03/14/2017

Effective Date

02/13/2018

Expiration Date

03/01/2020

City

BELLEVILLE

State

Zip

62226

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

12/18/2019