TERRA LACHELLE BABCOCK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002881

License Status

NOT RENEWED

Business

First Name

TERRA

Middle

LACHELLE

Last Name

BABCOCK

Business Name

TERRA LACHELLE BABCOCK

Original Issue Date

11/02/2006

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

09/22/2010