DAVID STINE HERIFORD Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002440

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

STINE

Last Name

HERIFORD

Business Name

DAVID STINE HERIFORD

Original Issue Date

12/28/2004

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

VIRGINIA

State

Zip

62691

County

CASS

Ever Disciplined

LastModifiedDate

11/18/2010

Case Number

2005006424

Action

Probation

Discipline Start Date

12/01/2005

Discipline End Date

11/30/2007

Discipline Reason

Disciplined in the state of Washington.