HEATHER C UPCHURCH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****52

License Status

NOT RENEWED

Business

First Name

HEATHER

Middle

Last Name

UPCHURCH

Business Name

HEATHER C UPCHURCH

Original Issue Date

03/27/2001

Effective Date

02/09/2012

Expiration Date

03/01/2014

City

BURR RIDGE

State

Zip

60527

County

DUPAGE

Ever Disciplined

LastModifiedDate

10/22/2015