RICHARD DOUGLAS WILSON Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000895

License Status

INACTIVE

Business

First Name

RICHARD

Middle

DOUGLAS

Last Name

WILSON

Business Name

RICHARD DOUGLAS WILSON

Original Issue Date

03/03/1997

Effective Date

02/22/2018

Expiration Date

03/01/2020

City

ALBANY

State

Zip

31705

County

GEORGIA

Ever Disciplined

LastModifiedDate

12/18/2019