RICHARD DOUGLAS WILSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****23

License Status

NOT RENEWED

Business

First Name

RICHARD

Middle

DOUGLAS

Last Name

WILSON

Business Name

RICHARD DOUGLAS WILSON

Original Issue Date

05/22/2001

Effective Date

05/22/2001

Expiration Date

03/01/2008

City

DANVILLE

State

Zip

61832

County

VERMILION

Ever Disciplined

LastModifiedDate

12/08/2015