CORY BELNAP Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****94

License Status

INOPERATIVE

Business

First Name

CORY

Last Name

BELNAP

Business Name

CORY BELNAP

Original Issue Date

10/28/2014

Effective Date

12/24/2019

Expiration Date

03/01/2022

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

01/03/2022