JASON DAVID PETERMAN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004001

License Status

NOT RENEWED

Business

First Name

JASON

Middle

DAVID

Last Name

PETERMAN

Business Name

JASON DAVID PETERMAN

Original Issue Date

03/02/2011

Effective Date

02/23/2016

Expiration Date

03/01/2018

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Ever Disciplined

LastModifiedDate

05/10/2018