JAMIE LYNN GILLETTE Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****52

License Status

INOPERATIVE

Business

First Name

JAMIE

Middle

LYNN

Last Name

GILLETTE

Business Name

JAMIE LYNN GILLETTE

Original Issue Date

10/15/2007

Effective Date

01/12/2012

Expiration Date

03/01/2014

City

SPRINGFIELD

State

Zip

62781

County

SANGAMON

Ever Disciplined

LastModifiedDate

11/15/2013