WAYNE E BLEVINS JR Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004267

License Status

ACTIVE

Business

First Name

WAYNE

Middle

Last Name

BLEVINS

Suffix

Business Name

WAYNE E BLEVINS JR

Original Issue Date

01/10/2012

Effective Date

12/03/2025

Expiration Date

03/01/2028

City

CARLINVILLE

State

Zip

62626

County

MACOUPIN

Ever Disciplined

LastModifiedDate

12/03/2025