LAUREN GRACE HEASTON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****87

License Status

NOT RENEWED

Business

First Name

LAUREN

Middle

GRACE

Last Name

HEASTON

Business Name

LAUREN GRACE HEASTON

Original Issue Date

08/25/2015

Effective Date

02/20/2018

Expiration Date

03/01/2020

City

PEORIA

State

Zip

61606

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020