CASEY L DAVIS Physician Assistant License verification

Business Entity

CANCELLED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****27

License Status

CANCELLED

Business

First Name

CASEY

Middle

Last Name

DAVIS

Business Name

CASEY L DAVIS

Original Issue Date

04/16/2010

Effective Date

04/16/2010

Expiration Date

03/01/2012

City

MARYVILLE

State

Zip

62062

County

MADISON

Ever Disciplined

LastModifiedDate

03/02/2012