SUSAN DEBOICE RODGERS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****53

License Status

NOT RENEWED

Business

First Name

SUSAN

Middle

DEBOICE

Last Name

RODGERS

Business Name

SUSAN DEBOICE RODGERS

Original Issue Date

07/03/2008

Effective Date

02/25/2020

Expiration Date

03/01/2022

City

SHELBYVILLE

State

Zip

40065

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022