DONALD THOMAS BEITZEL Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****30

License Status

INOPERATIVE

Business

First Name

DONALD

Middle

THOMAS

Last Name

BEITZEL

Business Name

DONALD THOMAS BEITZEL

Original Issue Date

01/02/2017

Effective Date

01/02/2017

Expiration Date

03/01/2018

City

GALESBURG

State

Zip

61401

County

KNOX

Ever Disciplined

LastModifiedDate

05/02/2018