COLLINE N GUSSE Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****06

License Status

ACTIVE

Business

First Name

COLLINE

Middle

Last Name

GUSSE

Business Name

COLLINE N GUSSE

Original Issue Date

05/21/2001

Effective Date

12/04/2025

Expiration Date

03/01/2028

City

DIXON

State

Zip

61021

County

LEE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/04/2025