JANET PIPER RUDDERHAM 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

JANET

Middle

PIPER

Last Name

RUDDERHAM

Business Name

JANET PIPER RUDDERHAM

Original Issue Date

03/17/2010

Effective Date

03/09/2018

Expiration Date

03/01/2020

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020