THOMAS WILLIAM MORAN 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

THOMAS

Middle

WILLIAM

Last Name

MORAN

Business Name

THOMAS WILLIAM MORAN

Original Issue Date

01/31/2006

Effective Date

01/25/2012

Expiration Date

03/01/2014

City

PONTIAC

State

Zip

61764

County

LIVINGSTON

Ever Disciplined

LastModifiedDate

04/08/2014