CAROLYN M BOOTH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****58

License Status

NOT RENEWED

Business

First Name

CAROLYN M

Last Name

BOOTH

Business Name

CAROLYN M BOOTH

Original Issue Date

03/13/2001

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

CENTREVILLE

State

Zip

62207

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

01/12/2009