ANDREW SEAN COSTERISAN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****89

License Status

NOT RENEWED

Business

First Name

ANDREW

Middle

SEAN

Last Name

COSTERISAN

Business Name

ANDREW SEAN COSTERISAN

Original Issue Date

05/05/2014

Effective Date

02/03/2022

Expiration Date

03/01/2024

City

SPRINGFIELD

State

Zip

62781

County

SANGAMON

Ever Disciplined

LastModifiedDate

02/05/2025