JAMIE LYNN HENGEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****30

License Status

NOT RENEWED

Business

First Name

JAMIE

Middle

LYNN

Last Name

HENGEN

Business Name

JAMIE LYNN HENGEN

Original Issue Date

11/23/2009

Effective Date

03/04/2010

Expiration Date

03/01/2012

City

GODFREY

State

Zip

62035

County

MADISON

Ever Disciplined

LastModifiedDate

08/06/2014