CONSTANCE MARIE GLEICH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000105

License Status

NOT RENEWED

Business

First Name

CONSTANCE MARIE

Last Name

GLEICH

Business Name

CONSTANCE MARIE GLEICH

Original Issue Date

01/25/1981

Effective Date

01/25/1981

Expiration Date

01/25/1985

City

TAYLORVILLE

State

Zip

62568

County

CHRISTIAN

Ever Disciplined

LastModifiedDate

09/26/2006