ERIC WILLIAM VICKREY 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

ERIC

Middle

WILLIAM

Last Name

VICKREY

Business Name

ERIC WILLIAM VICKREY

Original Issue Date

10/27/2003

Effective Date

01/15/2014

Expiration Date

03/01/2016

City

ELGIN

State

Zip

60123

County

KANE

Ever Disciplined

LastModifiedDate

08/04/2016