DAMARIS A AGE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004462

License Status

NOT RENEWED

Business

First Name

DAMARIS

Middle

Last Name

AGE

Business Name

DAMARIS A AGE

Original Issue Date

09/21/2012

Effective Date

03/01/2016

Expiration Date

03/01/2018

City

TOLONO

State

Zip

61880

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

05/10/2018