CRYSTAL ROSE FALKE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004243

License Status

NOT RENEWED

Business

First Name

CRYSTAL

Middle

ROSE

Last Name

FALKE

Business Name

CRYSTAL ROSE FALKE

Original Issue Date

11/07/2011

Effective Date

01/18/2022

Expiration Date

03/01/2024

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

02/05/2025