ALLISON A BUSUITO Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005635

License Status

NOT RENEWED

Business

First Name

ALLISON

Middle

Last Name

BUSUITO

Business Name

ALLISON A BUSUITO

Original Issue Date

09/17/2015

Effective Date

02/09/2016

Expiration Date

03/01/2018

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

05/10/2018