AMMON RAY WADDELL Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****38

License Status

NOT RENEWED

Business

First Name

AMMON

Middle

RAY

Last Name

WADDELL

Business Name

AMMON RAY WADDELL

Original Issue Date

06/02/2017

Effective Date

06/02/2017

Expiration Date

03/01/2018

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Ever Disciplined

LastModifiedDate

06/05/2018