GARREN R GILES Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****66

License Status

INACTIVE

Business

First Name

GARREN

Middle

Last Name

GILES

Business Name

GARREN R GILES

Original Issue Date

07/31/2008

Effective Date

06/23/2014

Expiration Date

03/01/2016

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

11/18/2014