LAUREN AMANDA SPANO Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007210

License Status

NOT RENEWED

Business

First Name

LAUREN

Middle

AMANDA

Last Name

SPANO

Business Name

LAUREN AMANDA SPANO

Original Issue Date

08/16/2019

Effective Date

08/16/2019

Expiration Date

03/01/2020

City

PEORIA

State

Zip

85383

Ever Disciplined

LastModifiedDate

11/24/2020