THERESA L CROWDER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****90

License Status

NOT RENEWED

Business

First Name

THERESA

Middle

Last Name

CROWDER

Business Name

THERESA L CROWDER

Original Issue Date

12/14/2006

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

GILMAN

State

Zip

60938

County

IROQUOIS

Ever Disciplined

LastModifiedDate

05/05/2009