CASEY LYNN WEGENER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****79

License Status

NOT RENEWED

Business

First Name

CASEY

Middle

LYNN

Last Name

WEGENER

Business Name

CASEY LYNN WEGENER

Original Issue Date

06/19/2015

Effective Date

06/19/2015

Expiration Date

03/01/2016

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

06/09/2016