JON DAVID ALLISON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****92

License Status

NOT RENEWED

Business

First Name

JON

Middle

DAVID

Last Name

ALLISON

Business Name

JON DAVID ALLISON

Original Issue Date

06/02/2004

Effective Date

06/02/2004

Expiration Date

03/01/2006

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

10/09/2006