IAN P HART Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****29

License Status

NOT RENEWED

Business

First Name

IAN

Middle

Last Name

HART

Business Name

IAN P HART

Original Issue Date

09/12/2017

Effective Date

12/24/2019

Expiration Date

03/01/2022

City

SILVIS

State

Zip

61282

County

ROCK ISLAND

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022