EDWIN W MCCAMMACK 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

EDWIN W

Last Name

MCCAMMACK

Business Name

EDWIN W MCCAMMACK

Original Issue Date

03/12/2001

Effective Date

05/11/2018

Expiration Date

03/01/2020

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

11/24/2020