BEN BURROUGHS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****41

License Status

NOT RENEWED

Business

First Name

BEN

Last Name

BURROUGHS

Business Name

BEN BURROUGHS

Original Issue Date

01/02/2020

Effective Date

01/02/2020

Expiration Date

03/01/2022

City

DECATUR

State

Zip

62526

County

MACON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022