TRACY LYNN HEETLAND Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005332

License Status

NOT RENEWED

Business

First Name

TRACY

Middle

LYNN

Last Name

HEETLAND

Business Name

TRACY LYNN HEETLAND

Original Issue Date

10/21/2014

Effective Date

02/19/2016

Expiration Date

03/01/2018

City

BURBANK

State

Zip

60459

County

COOK

Ever Disciplined

LastModifiedDate

05/10/2018