JON ROBERT HUMISTON Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****28

License Status

INOPERATIVE

Business

First Name

JON

Middle

ROBERT

Last Name

HUMISTON

Business Name

JON ROBERT HUMISTON

Original Issue Date

03/19/2015

Effective Date

02/09/2018

Expiration Date

03/01/2020

City

QUINCY

State

Zip

62301

County

ADAMS

Ever Disciplined

LastModifiedDate

12/18/2019