M COLLEEN CANAVAN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000651

License Status

NOT RENEWED

Business

First Name

Middle

COLLEEN

Last Name

CANAVAN

Business Name

M COLLEEN CANAVAN

Original Issue Date

12/20/1994

Effective Date

02/22/2018

Expiration Date

03/01/2020

City

JERSEYVILLE

State

Zip

62052

County

JERSEY

Ever Disciplined

LastModifiedDate

11/24/2020