ANDREW GARRETT WEGENER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005405

License Status

NOT RENEWED

Business

First Name

ANDREW

Middle

GARRETT

Last Name

WEGENER

Business Name

ANDREW GARRETT WEGENER

Original Issue Date

02/06/2015

Effective Date

02/06/2015

Expiration Date

03/01/2016

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Ever Disciplined

LastModifiedDate

04/25/2016