JODY L FARREY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002183

License Status

NOT RENEWED

Business

First Name

JODY

Middle

Last Name

FARREY

Business Name

JODY L FARREY

Original Issue Date

11/06/2003

Effective Date

11/06/2003

Expiration Date

03/01/2008

City

DANVILLE

State

Zip

61832

County

VERMILION

Ever Disciplined

LastModifiedDate

04/23/2008