DONALD THOMAS BEITZEL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085006091

License Status

NOT RENEWED

Business

First Name

DONALD

Middle

THOMAS

Last Name

BEITZEL

Business Name

DONALD THOMAS BEITZEL

Original Issue Date

12/15/2016

Effective Date

12/15/2016

Expiration Date

03/01/2018

City

GALESBURG

State

Zip

61401

County

KNOX

Ever Disciplined

LastModifiedDate

05/10/2018