KELSI RYAN WALTERS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****45

License Status

NOT RENEWED

Business

First Name

KELSI

Middle

RYAN

Last Name

WALTERS

Business Name

KELSI RYAN WALTERS

Original Issue Date

09/22/2010

Effective Date

09/22/2010

Expiration Date

03/01/2012

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

12/28/2015