LINDSEY C POULSEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****21

License Status

NOT RENEWED

Business

First Name

LINDSEY

Middle

Last Name

POULSEN

Business Name

LINDSEY C POULSEN

Original Issue Date

03/26/2001

Effective Date

03/26/2001

Expiration Date

03/01/2008

City

PEKIN

State

Zip

61554

County

TAZEWELL

Ever Disciplined

LastModifiedDate

03/07/2008