TIFFANI A BOTTS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005564

License Status

NOT RENEWED

Business

First Name

TIFFANI

Middle

Last Name

BOTTS

Business Name

TIFFANI A BOTTS

Original Issue Date

07/17/2015

Effective Date

02/05/2016

Expiration Date

03/01/2018

City

NAPERVILLE

State

Zip

60563

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/10/2018