TANYA K GUNTLY 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

TANYA

Middle

Last Name

GUNTLY

Business Name

TANYA K GUNTLY

Original Issue Date

12/21/2011

Effective Date

02/11/2014

Expiration Date

03/01/2016

City

FREEPORT

State

Zip

61032

County

STEPHENSON

Ever Disciplined

LastModifiedDate

03/24/2016