JAMILA LEE PETTERSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****17

License Status

NOT RENEWED

Business

First Name

JAMILA

Middle

LEE

Last Name

PETTERSON

Business Name

JAMILA LEE PETTERSON

Original Issue Date

05/22/2001

Effective Date

05/22/2001

Expiration Date

03/01/2006

City

SCOTT AIR FORCE BASE

State

Zip

62225

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

09/26/2006