GARY W SLATER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000374

License Status

NOT RENEWED

Business

First Name

GARY W

Last Name

SLATER

Business Name

GARY W SLATER

Original Issue Date

12/27/1988

Effective Date

02/26/2018

Expiration Date

03/01/2020

City

MAHOMET

State

Zip

61853

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

11/24/2020