BARBARA JEAN DAVIS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****71

License Status

NOT RENEWED

Business

First Name

BARBARA

Middle

JEAN

Last Name

DAVIS

Business Name

BARBARA JEAN DAVIS

Original Issue Date

07/09/2002

Effective Date

07/09/2002

Expiration Date

03/01/2004

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/09/2006