ANDREA NICOLE CAMPBELL Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****75

License Status

INOPERATIVE

Business

First Name

ANDREA

Middle

NICOLE

Last Name

CAMPBELL

Business Name

ANDREA NICOLE CAMPBELL

Original Issue Date

06/19/2018

Effective Date

06/19/2018

Expiration Date

03/01/2020

City

SWANSEA

State

Zip

62226

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

12/18/2019