JACLYN MARIE THOBABEN Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****12

License Status

INOPERATIVE

Business

First Name

JACLYN

Middle

MARIE

Last Name

THOBABEN

Business Name

JACLYN MARIE THOBABEN

Original Issue Date

06/25/2014

Effective Date

02/10/2016

Expiration Date

03/01/2018

City

QUINCY

State

Zip

62301

County

ADAMS

Ever Disciplined

LastModifiedDate

05/02/2018