VAN ERIC LAMORE Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****51

License Status

INOPERATIVE

Business

First Name

VAN

Middle

ERIC

Last Name

LAMORE

Business Name

VAN ERIC LAMORE

Original Issue Date

05/15/2002

Effective Date

09/11/2012

Expiration Date

03/01/2014

City

CREST HILL

State

Zip

60403

County

WILL

Ever Disciplined

LastModifiedDate

10/29/2012