ROLAND C FULL Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000031

License Status

INACTIVE

Business

First Name

ROLAND

Middle

Last Name

FULL

Business Name

ROLAND C FULL

Original Issue Date

11/05/1980

Effective Date

11/05/1980

Expiration Date

03/01/2004

City

GALESBURG

State

Zip

61401

County

KNOX

Ever Disciplined

LastModifiedDate

10/09/2006