SHANE WYATT KESLER Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004441

License Status

NOT RENEWED

Business

First Name

SHANE

Middle

WYATT

Last Name

KESLER

Business Name

SHANE WYATT KESLER

Original Issue Date

09/11/2012

Effective Date

09/11/2012

Expiration Date

03/01/2014

City

BLOOMINGTON

State

Zip

61705

County

MCLEAN

Ever Disciplined

LastModifiedDate

04/08/2014