THEODORE JAMES HEGNER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****88

License Status

NOT RENEWED

Business

First Name

THEODORE

Middle

JAMES

Last Name

HEGNER

Business Name

THEODORE JAMES HEGNER

Original Issue Date

08/17/2016

Effective Date

02/23/2018

Expiration Date

03/01/2020

City

STERLING

State

Zip

61081

County

WHITESIDE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020