THAMARA VALAIS 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

THAMARA

Last Name

VALAIS

Business Name

THAMARA VALAIS

Original Issue Date

09/16/2010

Effective Date

04/02/2012

Expiration Date

03/01/2014

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/01/2015