LARRY OSCAR LEYDERMAN Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****36

License Status

INOPERATIVE

Business

First Name

LARRY

Middle

OSCAR

Last Name

LEYDERMAN

Business Name

LARRY OSCAR LEYDERMAN

Original Issue Date

01/23/2012

Effective Date

02/26/2014

Expiration Date

03/01/2016

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Ever Disciplined

LastModifiedDate

07/01/2014