BRIE B TERRELL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****46

License Status

NOT RENEWED

Business

First Name

BRIE

Middle

Last Name

TERRELL

Business Name

BRIE B TERRELL

Original Issue Date

06/30/2008

Effective Date

02/16/2012

Expiration Date

03/01/2014

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

10/29/2015