BREANNA LYNN WARD Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****61

License Status

NOT RENEWED

Business

First Name

BREANNA

Middle

LYNN

Last Name

WARD

Business Name

BREANNA LYNN WARD

Original Issue Date

06/18/2019

Effective Date

01/08/2022

Expiration Date

03/01/2024

City

DAVENPORT

State

Zip

52807

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025