JANET LYNN MIEDEMA Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****43

License Status

NOT RENEWED

Business

First Name

JANET

Middle

LYNN

Last Name

MIEDEMA

Business Name

JANET LYNN MIEDEMA

Original Issue Date

09/08/2009

Effective Date

01/04/2012

Expiration Date

03/01/2014

City

EVANSTON

State

Zip

60202

County

COOK

Ever Disciplined

LastModifiedDate

10/22/2014