CLAIR LAURENT VISCONTI PA-C Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****78

License Status

NOT RENEWED

Business

Title

PA-C

First Name

CLAIR

Middle

LAURENT

Last Name

VISCONTI

Business Name

CLAIR LAURENT VISCONTI PA-C

Original Issue Date

01/27/2020

Effective Date

01/27/2020

Expiration Date

03/01/2022

City

ALTON

State

Zip

62002

County

MADISON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022