JON ROBERT HUMISTON - Physician Assistant License in Illinois | # 085005367

JON ROBERT HUMISTON

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005367

License Status

NOT RENEWED

Business

N

First Name

JON

Middle

ROBERT

Last Name

HUMISTON

Business Name

JON ROBERT HUMISTON

Original Issue Date

12/15/2014

Effective Date

02/09/2018

Expiration Date

03/01/2020

State

IL

Ever Disciplined

N

LastModifiedDate

11/24/2020