ANDREA REGINA COLEN Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002071

License Status

INACTIVE

Business

First Name

ANDREA

Middle

REGINA

Last Name

COLEN

Business Name

ANDREA REGINA COLEN

Original Issue Date

09/03/2003

Effective Date

09/03/2003

Expiration Date

03/01/2006

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

10/09/2006