AMY L BETANCOURT 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

AMY

Middle

Last Name

BETANCOURT

Business Name

AMY L BETANCOURT

Original Issue Date

09/03/2003

Effective Date

09/03/2003

Expiration Date

03/01/2006

City

ZION

State

Zip

60099

County

LAKE

Ever Disciplined

LastModifiedDate

10/09/2006