DEAN RYAN DAVIS MD Physician Assistant License verification

Business Entity

CANCELLED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001606

License Status

CANCELLED

Business

Title

First Name

DEAN

Middle

RYAN

Last Name

DAVIS

Business Name

DEAN RYAN DAVIS MD

Original Issue Date

07/17/2001

Effective Date

02/03/2016

Expiration Date

03/01/2018

City

DECATUR

State

Zip

62526

County

MACON

Ever Disciplined

LastModifiedDate

11/20/2017