VIRGINIA ANNE EVANS 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

VIRGINIA

Middle

ANNE

Last Name

EVANS

Business Name

VIRGINIA ANNE EVANS

Original Issue Date

08/16/2005

Effective Date

08/16/2005

Expiration Date

03/01/2008

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

12/06/2007