ANDREA ROSE KOERNER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****62

License Status

NOT RENEWED

Business

First Name

ANDREA

Middle

ROSE

Last Name

KOERNER

Business Name

ANDREA ROSE KOERNER

Original Issue Date

10/31/2019

Effective Date

01/14/2020

Expiration Date

03/01/2022

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022