KRISTA DECOURSEY WASHBURN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005580

License Status

NOT RENEWED

Business

First Name

KRISTA

Middle

DECOURSEY

Last Name

WASHBURN

Business Name

KRISTA DECOURSEY WASHBURN

Original Issue Date

07/28/2015

Effective Date

12/24/2019

Expiration Date

03/01/2022

City

PEORIA

State

Zip

61604

Ever Disciplined

LastModifiedDate

07/27/2022