DOUGLAS ALAN EASTHAM Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****82

License Status

NOT RENEWED

Business

First Name

DOUGLAS

Middle

ALAN

Last Name

EASTHAM

Business Name

DOUGLAS ALAN EASTHAM

Original Issue Date

08/02/2010

Effective Date

02/25/2016

Expiration Date

03/01/2018

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/10/2018