HEATHER C UPCHURCH Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001177

License Status

INACTIVE

Business

First Name

HEATHER

Middle

Last Name

UPCHURCH

Business Name

HEATHER C UPCHURCH

Original Issue Date

01/12/1999

Effective Date

02/09/2012

Expiration Date

03/01/2014

City

PEKIN

State

Zip

61554

County

TAZEWELL

Ever Disciplined

LastModifiedDate

01/25/2016