ANDREA GAIL FURLONG Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****13

License Status

INOPERATIVE

Business

First Name

ANDREA

Middle

GAIL

Last Name

FURLONG

Business Name

ANDREA GAIL FURLONG

Original Issue Date

02/06/2013

Effective Date

02/10/2016

Expiration Date

03/01/2018

City

EFFINGHAM

State

Zip

62401

County

EFFINGHAM

Ever Disciplined

LastModifiedDate

05/02/2018