AMBER MARIE ABRAHAM Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****55

License Status

NOT RENEWED

Business

First Name

AMBER

Middle

MARIE

Last Name

ABRAHAM

Business Name

AMBER MARIE ABRAHAM

Original Issue Date

08/11/2014

Effective Date

08/11/2014

Expiration Date

03/01/2016

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

03/08/2016