AMY DENISE WILVERT Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****08

License Status

NOT RENEWED

Business

First Name

AMY

Middle

DENISE

Last Name

WILVERT

Business Name

AMY DENISE WILVERT

Original Issue Date

05/05/2011

Effective Date

04/02/2018

Expiration Date

03/01/2020

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020