MEGAN MARIE MICHAEL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004572

License Status

NOT RENEWED

Business

First Name

MEGAN

Middle

MARIE

Last Name

MICHAEL

Business Name

MEGAN MARIE MICHAEL

Original Issue Date

11/20/2012

Effective Date

02/13/2020

Expiration Date

03/01/2022

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/27/2022