TRACY LYNN HEETLAND Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****60

License Status

INOPERATIVE

Business

First Name

TRACY

Middle

LYNN

Last Name

HEETLAND

Business Name

TRACY LYNN HEETLAND

Original Issue Date

12/26/2014

Effective Date

02/19/2016

Expiration Date

03/01/2018

City

BURBANK

State

Zip

60459

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2018