MICHAEL R HOLMES Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****23

License Status

INOPERATIVE

Business

First Name

MICHAEL

Middle

Last Name

HOLMES

Business Name

MICHAEL R HOLMES

Original Issue Date

10/22/2012

Effective Date

01/29/2014

Expiration Date

03/01/2016

City

BRADLEY

State

Zip

60915

County

KANKAKEE

Ever Disciplined

LastModifiedDate

03/20/2015