AMMON RAY WADDELL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085006199

License Status

NOT RENEWED

Business

First Name

AMMON

Middle

RAY

Last Name

WADDELL

Business Name

AMMON RAY WADDELL

Original Issue Date

06/02/2017

Effective Date

03/29/2018

Expiration Date

03/01/2020

City

RICHMOND HILL

State

Zip

31324

Ever Disciplined

LastModifiedDate

11/24/2020