ALLISON JEAN MODGLIN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****97

License Status

NOT RENEWED

Business

First Name

ALLISON

Middle

JEAN

Last Name

MODGLIN

Business Name

ALLISON JEAN MODGLIN

Original Issue Date

09/03/2015

Effective Date

09/03/2015

Expiration Date

03/01/2016

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

01/21/2016