LEAH MARIE CLEM Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****28

License Status

NOT RENEWED

Business

First Name

LEAH

Middle

MARIE

Last Name

CLEM

Business Name

LEAH MARIE CLEM

Original Issue Date

02/03/2009

Effective Date

03/01/2018

Expiration Date

03/01/2020

City

CENTRALIA

State

Zip

62801

County

MARION

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020