BRIAN E COOK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****27

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

Last Name

COOK

Business Name

BRIAN E COOK

Original Issue Date

12/06/2007

Effective Date

12/06/2007

Expiration Date

03/01/2010

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

09/23/2010