CAMERON TROY JACKSON STENGEL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007271

License Status

NOT RENEWED

Business

First Name

CAMERON

Middle

TROY JACKSON

Last Name

STENGEL

Business Name

CAMERON TROY JACKSON STENGEL

Original Issue Date

09/14/2019

Effective Date

12/27/2019

Expiration Date

03/01/2022

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

07/27/2022