MARY JO POREMBA Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****83

License Status

INOPERATIVE

Business

First Name

MARY JO

Last Name

POREMBA

Business Name

MARY JO POREMBA

Original Issue Date

03/16/2001

Effective Date

02/25/2016

Expiration Date

03/01/2018

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

05/02/2018