CARRIE LYNN STEPHEN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****51

License Status

NOT RENEWED

Business

First Name

CARRIE

Middle

LYNN

Last Name

STEPHEN

Business Name

CARRIE LYNN STEPHEN

Original Issue Date

06/23/2010

Effective Date

01/21/2014

Expiration Date

03/01/2016

City

PEORIA

State

Zip

61603

County

PEORIA

Ever Disciplined

LastModifiedDate

01/25/2017