MEGAN MICHELLE MOSER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****03

License Status

NOT RENEWED

Business

First Name

MEGAN

Middle

MICHELLE

Last Name

MOSER

Business Name

MEGAN MICHELLE MOSER

Original Issue Date

06/02/2004

Effective Date

06/02/2004

Expiration Date

03/01/2006

City

TINLEY PARK

State

Zip

60477

County

COOK

Ever Disciplined

LastModifiedDate

09/26/2006