MARY JO BLOOMINGER 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

MARY JO

Last Name

BLOOMINGER

Business Name

MARY JO BLOOMINGER

Original Issue Date

02/06/2003

Effective Date

02/26/2016

Expiration Date

03/01/2018

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

05/10/2018