AMY M GOETZ Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****72

License Status

NOT RENEWED

Business

First Name

AMY

Middle

Last Name

GOETZ

Business Name

AMY M GOETZ

Original Issue Date

05/09/2007

Effective Date

01/23/2014

Expiration Date

03/01/2016

City

HERRIN

State

Zip

62948

County

WILLIAMSON

Ever Disciplined

LastModifiedDate

04/25/2016