KEITH BRYAN GUESS Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001376

License Status

INACTIVE

Business

First Name

KEITH

Middle

BRYAN

Last Name

GUESS

Business Name

KEITH BRYAN GUESS

Original Issue Date

04/17/2000

Effective Date

02/11/2010

Expiration Date

03/01/2012

City

WARSAW

State

Zip

62379

County

HANCOCK

Ever Disciplined

LastModifiedDate

12/07/2011