SCOTT DOUGLAS THOMPSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****50

License Status

NOT RENEWED

Business

First Name

SCOTT

Middle

DOUGLAS

Last Name

THOMPSON

Business Name

SCOTT DOUGLAS THOMPSON

Original Issue Date

01/31/2005

Effective Date

01/31/2005

Expiration Date

03/01/2008

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

08/15/2007