LAURIE A TIBBS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****91

License Status

NOT RENEWED

Business

First Name

LAURIE

Middle

Last Name

TIBBS

Business Name

LAURIE A TIBBS

Original Issue Date

05/03/2001

Effective Date

02/20/2018

Expiration Date

03/01/2020

City

DANVILLE

State

Zip

61832

County

VERMILION

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020