M COLLEEN CANAVAN Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****39

License Status

INOPERATIVE

Business

First Name

Middle

COLLEEN

Last Name

CANAVAN

Business Name

M COLLEEN CANAVAN

Original Issue Date

03/22/2001

Effective Date

02/22/2018

Expiration Date

03/01/2020

City

JERSEYVILLE

State

Zip

62052

County

JERSEY

Ever Disciplined

LastModifiedDate

12/18/2019