BRAD LYN HARTWIG Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****07

License Status

NOT RENEWED

Business

First Name

BRAD

Middle

LYN

Last Name

HARTWIG

Business Name

BRAD LYN HARTWIG

Original Issue Date

03/12/2008

Effective Date

03/12/2008

Expiration Date

03/01/2010

City

MACHESNEY PARK

State

Zip

61115

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

01/08/2009