MARC WILLIAM GOODBOY 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

MARC

Middle

WILLIAM

Last Name

GOODBOY

Business Name

MARC WILLIAM GOODBOY

Original Issue Date

01/05/2021

Effective Date

01/05/2021

Expiration Date

03/01/2022

City

URBANA

State

Zip

61801

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022