TINIKI RANARD WHITE 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

TINIKI

Middle

RANARD

Last Name

WHITE

Business Name

TINIKI RANARD WHITE

Original Issue Date

12/23/2010

Effective Date

12/19/2011

Expiration Date

03/01/2014

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Ever Disciplined

LastModifiedDate

12/02/2015