SARA R AVERY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****85

License Status

NOT RENEWED

Business

First Name

SARA

Middle

Last Name

AVERY

Business Name

SARA R AVERY

Original Issue Date

08/25/2015

Effective Date

02/22/2018

Expiration Date

03/01/2020

City

ROSCOE

State

Zip

61073

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020