MEREDITH ANN WICKLINE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****38

License Status

NOT RENEWED

Business

First Name

MEREDITH

Middle

ANN

Last Name

WICKLINE

Business Name

MEREDITH ANN WICKLINE

Original Issue Date

01/20/2005

Effective Date

01/20/2005

Expiration Date

03/01/2006

City

NAPERVILLE

State

Zip

60540

County

DUPAGE

Ever Disciplined

LastModifiedDate

10/09/2006