JUSTIN THOMAS BLACKMON - Physician Assistant License in Illinois | # 085005596

JUSTIN THOMAS BLACKMON

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005596

License Status

NOT RENEWED

Business

N

First Name

JUSTIN

Middle

THOMAS

Last Name

BLACKMON

Business Name

JUSTIN THOMAS BLACKMON

Original Issue Date

08/11/2015

Effective Date

02/19/2016

Expiration Date

03/01/2018

State

IL

Ever Disciplined

N

LastModifiedDate

07/28/2025