LESLIE THARON CRANICK 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

LESLIE

Middle

THARON

Last Name

CRANICK

Business Name

LESLIE THARON CRANICK

Original Issue Date

08/22/2003

Effective Date

02/15/2018

Expiration Date

03/01/2020

City

MARION

State

Zip

62959

County

WILLIAMSON

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

11/24/2020