JASON KENDALL WALLS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001763

License Status

NOT RENEWED

Business

First Name

JASON

Middle

KENDALL

Last Name

WALLS

Business Name

JASON KENDALL WALLS

Original Issue Date

02/06/2002

Effective Date

02/06/2002

Expiration Date

03/01/2004

City

HIGHWOOD

State

Zip

60040

County

LAKE

Ever Disciplined

LastModifiedDate

10/09/2006