TARA R TRENT Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004940

License Status

NOT RENEWED

Business

First Name

TARA

Middle

Last Name

TRENT

Business Name

TARA R TRENT

Original Issue Date

10/30/2013

Effective Date

02/25/2016

Expiration Date

03/01/2018

City

SPRINGFIELD

State

Zip

62781

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/10/2018