KAYLI M P CLATTERBUCK Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****90

License Status

INOPERATIVE

Business

First Name

KAYLI

Middle

M P

Last Name

CLATTERBUCK

Business Name

KAYLI M P CLATTERBUCK

Original Issue Date

01/29/2013

Effective Date

02/20/2014

Expiration Date

03/01/2016

City

PEORIA

State

Zip

61637

County

PEORIA

Ever Disciplined

LastModifiedDate

07/02/2014