EDWIN W MCCAMMACK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000055

License Status

NOT RENEWED

Business

First Name

EDWIN W

Last Name

MCCAMMACK

Business Name

EDWIN W MCCAMMACK

Original Issue Date

11/30/1980

Effective Date

05/11/2018

Expiration Date

03/01/2020

City

URBANA

State

Zip

61802

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

11/24/2020