RACHEL C FIDDYMENT 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

RACHEL

Middle

Last Name

FIDDYMENT

Business Name

RACHEL C FIDDYMENT

Original Issue Date

12/30/2005

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

ST CHARLES

State

Zip

60174

County

KANE

Ever Disciplined

LastModifiedDate

10/13/2009