PATRICIA LEE MONTGOMERY Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****48

License Status

INOPERATIVE

Business

First Name

PATRICIA

Middle

LEE

Last Name

MONTGOMERY

Business Name

PATRICIA LEE MONTGOMERY

Original Issue Date

02/22/2001

Effective Date

02/23/2018

Expiration Date

03/01/2020

City

MATTOON

State

Zip

61938

County

COLES

Ever Disciplined

LastModifiedDate

12/18/2019