AMY M GOETZ Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002812

License Status

NOT RENEWED

Business

First Name

AMY

Middle

Last Name

GOETZ

Business Name

AMY M GOETZ

Original Issue Date

09/08/2006

Effective Date

01/23/2014

Expiration Date

03/01/2016

City

CARTERVILLE

State

Zip

62918

County

WILLIAMSON

Ever Disciplined

LastModifiedDate

04/25/2016