CARISSA LYNN PARDEKOOPER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005227

License Status

NOT RENEWED

Business

First Name

CARISSA

Middle

LYNN

Last Name

PARDEKOOPER

Business Name

CARISSA LYNN PARDEKOOPER

Original Issue Date

09/16/2014

Effective Date

01/30/2020

Expiration Date

03/01/2022

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

07/27/2022