EASTON IZAAK MANN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085006960

License Status

NOT RENEWED

Business

First Name

EASTON

Middle

IZAAK

Last Name

MANN

Business Name

EASTON IZAAK MANN

Original Issue Date

03/06/2019

Effective Date

12/30/2019

Expiration Date

03/01/2022

City

BELLEVILLE

State

Zip

62223

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

07/27/2022