JEFFREY K BUCKINGHAM Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001258

License Status

NOT RENEWED

Business

First Name

JEFFREY

Middle

Last Name

BUCKINGHAM

Business Name

JEFFREY K BUCKINGHAM

Original Issue Date

12/23/1999

Effective Date

02/11/2016

Expiration Date

03/01/2018

City

PEORIA

State

Zip

61604

County

PEORIA

Ever Disciplined

LastModifiedDate

05/10/2018