JAMIE LYNN TICGELAOR Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****20

License Status

NOT RENEWED

Business

First Name

JAMIE

Middle

LYNN

Last Name

TICGELAOR

Business Name

JAMIE LYNN TICGELAOR

Original Issue Date

03/26/2002

Effective Date

03/26/2002

Expiration Date

03/01/2004

City

SWANSEA

State

Zip

62226

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

10/09/2006