KELLY ANN GABA Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****01

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

ANN

Last Name

GABA

Business Name

KELLY ANN GABA

Original Issue Date

11/14/2003

Effective Date

01/22/2014

Expiration Date

03/01/2016

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

01/21/2016