LOREN CLAIRE MARIE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002275

License Status

NOT RENEWED

Business

First Name

LOREN

Middle

CLAIRE

Last Name

MARIE

Business Name

LOREN CLAIRE MARIE

Original Issue Date

08/02/2004

Effective Date

02/10/2010

Expiration Date

03/01/2012

City

NORMAL

State

Zip

61761

County

MCLEAN

Ever Disciplined

LastModifiedDate

04/11/2012