SARAH JOANNA TEN EYCK Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****57

License Status

NOT RENEWED

Business

First Name

SARAH

Middle

JOANNA

Last Name

TEN EYCK

Business Name

SARAH JOANNA TEN EYCK

Original Issue Date

09/25/2009

Effective Date

03/12/2012

Expiration Date

03/01/2014

City

WAUKEGAN

State

Zip

60085

County

LAKE

Ever Disciplined

LastModifiedDate

10/28/2015