BRIAN E COOK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003153

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

Last Name

COOK

Business Name

BRIAN E COOK

Original Issue Date

11/16/2007

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

09/23/2010