STACY LYNN SUMMERS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****81

License Status

NOT RENEWED

Business

First Name

STACY

Middle

LYNN

Last Name

SUMMERS

Business Name

STACY LYNN SUMMERS

Original Issue Date

07/30/2010

Effective Date

01/21/2016

Expiration Date

03/01/2018

City

SPRINGFIELD

State

Zip

62769

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/10/2018