JASON DAVID PETERMAN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****86

License Status

NOT RENEWED

Business

First Name

JASON

Middle

DAVID

Last Name

PETERMAN

Business Name

JASON DAVID PETERMAN

Original Issue Date

03/09/2011

Effective Date

02/23/2016

Expiration Date

03/01/2018

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Ever Disciplined

LastModifiedDate

05/10/2018