HAROLD POOLE GILLIAN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000174

License Status

NOT RENEWED

Business

First Name

HAROLD POOLE

Last Name

GILLIAN

Business Name

HAROLD POOLE GILLIAN

Original Issue Date

02/14/1980

Effective Date

02/25/2016

Expiration Date

03/01/2018

City

GODFREY

State

Zip

62035

County

MADISON

Ever Disciplined

LastModifiedDate

05/10/2018