MARCUS ALAN ROMAN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002072

License Status

NOT RENEWED

Business

First Name

MARCUS

Middle

ALAN

Last Name

ROMAN

Business Name

MARCUS ALAN ROMAN

Original Issue Date

09/04/2003

Effective Date

02/13/2020

Expiration Date

03/01/2022

City

DUNLAP

State

Zip

61525

County

PEORIA

Ever Disciplined

LastModifiedDate

07/27/2022