BEN WARREN HARKINS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****34

License Status

NOT RENEWED

Business

First Name

BEN

Middle

WARREN

Last Name

HARKINS

Business Name

BEN WARREN HARKINS

Original Issue Date

02/15/2007

Effective Date

02/21/2018

Expiration Date

03/01/2020

City

PEORIA

State

Zip

61636

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020