REX E STOMBAUGH Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001351

License Status

INACTIVE

Business

First Name

REX

Middle

Last Name

STOMBAUGH

Business Name

REX E STOMBAUGH

Original Issue Date

02/08/2000

Effective Date

01/04/2012

Expiration Date

03/01/2014

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Ever Disciplined

LastModifiedDate

12/19/2013