ROBERT LEE DOUGHERTY Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****08

License Status

INOPERATIVE

Business

First Name

ROBERT

Middle

LEE

Last Name

DOUGHERTY

Business Name

ROBERT LEE DOUGHERTY

Original Issue Date

03/09/2001

Effective Date

01/21/2014

Expiration Date

03/01/2016

City

NEOGA

State

Zip

62447

County

CUMBERLAND

Ever Disciplined

LastModifiedDate

08/20/2014