ROBERT MANUEL BOUCHER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000205

License Status

NOT RENEWED

Business

First Name

ROBERT MANUEL

Last Name

BOUCHER

Business Name

ROBERT MANUEL BOUCHER

Original Issue Date

04/11/1980

Effective Date

04/11/1980

Expiration Date

03/01/1986

City

PEORIA

State

Zip

61603

County

PEORIA

Ever Disciplined

LastModifiedDate

09/26/2006