AMBER D LUTZ Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****76

License Status

NOT RENEWED

Business

First Name

AMBER

Middle

Last Name

LUTZ

Business Name

AMBER D LUTZ

Original Issue Date

03/15/2004

Effective Date

02/23/2012

Expiration Date

03/01/2014

City

FAIRFIELD

State

Zip

62837

County

WAYNE

Ever Disciplined

LastModifiedDate

01/08/2015