TAMARA LEE COOK 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

TAMARA

Middle

LEE

Last Name

COOK

Business Name

TAMARA LEE COOK

Original Issue Date

11/24/2004

Effective Date

11/24/2004

Expiration Date

03/01/2008

City

MORRISON

State

Zip

61270

County

WHITESIDE

Ever Disciplined

LastModifiedDate

02/23/2010