SUSAN KREBILL MACDOWELL Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****78

License Status

INOPERATIVE

Business

First Name

SUSAN

Middle

KREBILL

Last Name

MACDOWELL

Business Name

SUSAN KREBILL MACDOWELL

Original Issue Date

02/04/2010

Effective Date

02/23/2012

Expiration Date

03/01/2014

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

03/12/2021