PETER WALLACE LEWIS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004035

License Status

NOT RENEWED

Business

First Name

PETER

Middle

WALLACE

Last Name

LEWIS

Business Name

PETER WALLACE LEWIS

Original Issue Date

05/25/2011

Effective Date

02/22/2012

Expiration Date

03/01/2014

City

TRENTON

State

Zip

62293

County

CLINTON

Ever Disciplined

LastModifiedDate

04/08/2014