CRYSTAL L JOHNSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000361

License Status

NOT RENEWED

Business

First Name

CRYSTAL

Middle

Last Name

JOHNSON

Business Name

CRYSTAL L JOHNSON

Original Issue Date

07/20/1988

Effective Date

07/20/1988

Expiration Date

03/01/2002

City

PEORIA HEIGHTS

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

10/09/2006