KRISTIN RICHELLE BUSS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****12

License Status

NOT RENEWED

Business

First Name

KRISTIN

Middle

RICHELLE

Last Name

BUSS

Business Name

KRISTIN RICHELLE BUSS

Original Issue Date

12/20/2011

Effective Date

02/26/2016

Expiration Date

03/01/2018

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/10/2018