MICHELLE ALISE GARDNER-WOOD Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****37

License Status

NOT RENEWED

Business

First Name

MICHELLE

Middle

ALISE

Last Name

GARDNER-WOOD

Business Name

MICHELLE ALISE GARDNER-WOOD

Original Issue Date

09/15/2017

Effective Date

03/01/2022

Expiration Date

03/01/2024

City

PEORIA

State

Zip

61615

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025