MICHAEL J MCCORMICK Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****55

License Status

INOPERATIVE

Business

First Name

MICHAEL

Middle

Last Name

MCCORMICK

Business Name

MICHAEL J MCCORMICK

Original Issue Date

11/05/2008

Effective Date

02/03/2016

Expiration Date

03/01/2018

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/02/2018