ERICK DUANE ANDERSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****80

License Status

NOT RENEWED

Business

First Name

ERICK

Middle

DUANE

Last Name

ANDERSON

Business Name

ERICK DUANE ANDERSON

Original Issue Date

06/08/2009

Effective Date

02/11/2016

Expiration Date

03/01/2018

City

PEORIA

State

Zip

61602

County

PEORIA

Ever Disciplined

LastModifiedDate

05/10/2018