License holder summary

JONATHAN IAN LAKE is a Graduate Medical Trainee licensed to practice in Pennsylvania. The address on file for JONATHAN IAN LAKE is Saint Louis MO 63108. This medical practitioner license is current. The license was granted 04/16/2015 and expired on 06/18/2017.

Department of State

Board of Medicine

JONATHAN IAN LAKE
Graduate Medical Trainee
License number
MT208085
Date granted
04/16/2015
Date expires
06/18/2017
Class
Graduate Medical Trainee
Status
Active
Address
Saint Louis MO 63108
medicinepa.com
ID 37548098
LAST UPDATED 2021-05-01 19:37:19 UTC

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