ELIZABETH DIANE DASSOW Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****59

License Status

NOT RENEWED

Business

First Name

ELIZABETH

Middle

DIANE

Last Name

DASSOW

Business Name

ELIZABETH DIANE DASSOW

Original Issue Date

07/23/2020

Effective Date

01/13/2022

Expiration Date

03/01/2024

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025