DIANE RENEE COX Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****98

License Status

INOPERATIVE

Business

First Name

DIANE

Middle

RENEE

Last Name

COX

Business Name

DIANE RENEE COX

Original Issue Date

12/12/2011

Effective Date

03/09/2018

Expiration Date

03/01/2020

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

12/18/2019