WAYNE THOMAS WING Physician Assistant License verification

Business Entity

INACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001600

License Status

INACTIVE

Business

First Name

WAYNE

Middle

THOMAS

Last Name

WING

Business Name

WAYNE THOMAS WING

Original Issue Date

07/12/2001

Effective Date

01/25/2012

Expiration Date

03/01/2014

City

OGDEN

State

Zip

61859

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

12/22/2015