CARRIE LYNN STEPHEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003737

License Status

NOT RENEWED

Business

First Name

CARRIE

Middle

LYNN

Last Name

STEPHEN

Business Name

CARRIE LYNN STEPHEN

Original Issue Date

06/07/2010

Effective Date

01/21/2014

Expiration Date

03/01/2016

City

PEORIA

State

Zip

61603

County

PEORIA

Ever Disciplined

LastModifiedDate

01/25/2017