JONATHAN WAYNE BRUMMOND Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085006556

License Status

NOT RENEWED

Business

First Name

JONATHAN

Middle

WAYNE

Last Name

BRUMMOND

Business Name

JONATHAN WAYNE BRUMMOND

Original Issue Date

03/26/2018

Effective Date

03/26/2018

Expiration Date

03/01/2020

City

EMERYVILLE

State

Zip

94608

Ever Disciplined

LastModifiedDate

11/24/2020