FAYE A BRANUM Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004339

License Status

NOT RENEWED

Business

First Name

FAYE

Middle

Last Name

BRANUM

Business Name

FAYE A BRANUM

Original Issue Date

07/03/2012

Effective Date

01/12/2022

Expiration Date

03/01/2024

City

CARBONDALE

State

Zip

62902

County

JACKSON

Ever Disciplined

LastModifiedDate

02/05/2025