AMBER ZOE GORHAM Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****75

License Status

NOT RENEWED

Business

First Name

AMBER

Middle

ZOE

Last Name

GORHAM

Business Name

AMBER ZOE GORHAM

Original Issue Date

08/13/2008

Effective Date

01/23/2014

Expiration Date

03/01/2016

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

04/25/2016