SALLY CAMPBELL 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

SALLY

Last Name

CAMPBELL

Business Name

SALLY CAMPBELL

Original Issue Date

04/05/2018

Effective Date

04/05/2018

Expiration Date

03/01/2020

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020