HILARY LORRAINE EICKHOFF Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****41

License Status

NOT RENEWED

Business

First Name

HILARY

Middle

LORRAINE

Last Name

EICKHOFF

Business Name

HILARY LORRAINE EICKHOFF

Original Issue Date

11/04/2021

Effective Date

11/04/2021

Expiration Date

03/01/2022

City

MARION

State

Zip

62959

County

WILLIAMSON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022