STEPHANIE LEANNE YNIGUEZ 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

STEPHANIE

Middle

LEANNE

Last Name

YNIGUEZ

Business Name

STEPHANIE LEANNE YNIGUEZ

Original Issue Date

06/17/2016

Effective Date

03/01/2018

Expiration Date

03/01/2020

City

ALTON

State

Zip

62002

County

MADISON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020