SARA MARIE DICKEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001982

License Status

NOT RENEWED

Business

First Name

SARA

Middle

MARIE

Last Name

DICKEN

Business Name

SARA MARIE DICKEN

Original Issue Date

02/11/2003

Effective Date

01/19/2010

Expiration Date

03/01/2012

City

LONG GROVE

State

Zip

52756

County

SCOTT

Ever Disciplined

LastModifiedDate

07/20/2012