JON ROBERT HUMISTON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085005367

License Status

NOT RENEWED

Business

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

City

QUINCY

State

Zip

62301

County

ADAMS

Ever Disciplined

LastModifiedDate

11/24/2020