AMY WELLS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002405

License Status

NOT RENEWED

Business

First Name

AMY

Last Name

WELLS

Business Name

AMY WELLS

Original Issue Date

10/29/2004

Effective Date

02/17/2010

Expiration Date

03/01/2012

City

CARBONDALE

State

Zip

62902

County

JACKSON

Ever Disciplined

LastModifiedDate

11/20/2015