JACK G WENDELL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000169

License Status

NOT RENEWED

Business

First Name

JACK G

Last Name

WENDELL

Business Name

JACK G WENDELL

Original Issue Date

04/14/1977

Effective Date

04/14/1977

Expiration Date

04/14/1979

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

09/26/2006