ANTON JARED WIEBEL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****66

License Status

NOT RENEWED

Business

First Name

ANTON

Middle

JARED

Last Name

WIEBEL

Business Name

ANTON JARED WIEBEL

Original Issue Date

07/13/2010

Effective Date

02/25/2014

Expiration Date

03/01/2016

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

03/17/2016