JEFFREY K BUCKINGHAM Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****56

License Status

NOT RENEWED

Business

First Name

JEFFREY

Middle

Last Name

BUCKINGHAM

Business Name

JEFFREY K BUCKINGHAM

Original Issue Date

01/28/2002

Effective Date

02/11/2016

Expiration Date

03/01/2018

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

05/10/2018