ANN MARIE PATTY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****94

License Status

NOT RENEWED

Business

First Name

ANN

Middle

MARIE

Last Name

PATTY

Business Name

ANN MARIE PATTY

Original Issue Date

10/28/2010

Effective Date

03/05/2018

Expiration Date

03/01/2020

City

MONMOUTH

State

Zip

61462

County

WARREN

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020