Krista Jordan Blackstone
SuspendedMichigan license 5601007463
License
- Licensed by
- Michigan Department of Licensing and Regulatory Affairs
- License number
- 5601007463
- Status
- Suspended
- First issued
- April 24, 2019
- Expires
- April 24, 2028
- License holder
- Krista Jordan Blackstone
- Entity type
- Individual
Classifications
- Physicians Assistant Physicians & Surgeons