JENNIFER L STOREY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004599

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

Last Name

STOREY

Business Name

JENNIFER L STOREY

Original Issue Date

01/14/2013

Effective Date

01/14/2013

Expiration Date

03/01/2014

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Ever Disciplined

LastModifiedDate

04/08/2014