GORDON G EGGERS JR Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****47

License Status

INOPERATIVE

Business

First Name

GORDON G

Last Name

EGGERS JR

Business Name

GORDON G EGGERS JR

Original Issue Date

05/13/2002

Effective Date

02/26/2018

Expiration Date

03/01/2020

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

12/18/2019