PETER WALLACE LEWIS 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

PETER

Middle

WALLACE

Last Name

LEWIS

Business Name

PETER WALLACE LEWIS

Original Issue Date

09/19/2011

Effective Date

02/22/2012

Expiration Date

03/01/2014

City

SESSER

State

Zip

62884

County

FRANKLIN

Ever Disciplined

LastModifiedDate

04/12/2013