MONICA DIANE PRICHARD Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****17

License Status

INOPERATIVE

Business

First Name

MONICA

Middle

DIANE

Last Name

PRICHARD

Business Name

MONICA DIANE PRICHARD

Original Issue Date

08/20/2019

Effective Date

01/24/2020

Expiration Date

03/01/2022

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

01/03/2022