GRACE ASHLEY HENDERSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007929

License Status

NOT RENEWED

Business

First Name

GRACE

Middle

ASHLEY

Last Name

HENDERSON

Business Name

GRACE ASHLEY HENDERSON

Original Issue Date

09/09/2020

Effective Date

09/09/2020

Expiration Date

03/01/2022

City

PEORIA

State

Zip

61606

County

PEORIA

Ever Disciplined

LastModifiedDate

07/27/2022