LISA MARIE REPKO Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****69

License Status

INOPERATIVE

Business

First Name

LISA

Middle

MARIE

Last Name

REPKO

Business Name

LISA MARIE REPKO

Original Issue Date

03/11/2004

Effective Date

02/25/2014

Expiration Date

03/01/2016

City

DANVILLE

State

Zip

61832

Ever Disciplined

LastModifiedDate

07/07/2015