BRANDI NICOLE HUME Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****43

License Status

NOT RENEWED

Business

First Name

BRANDI

Middle

NICOLE

Last Name

HUME

Business Name

BRANDI NICOLE HUME

Original Issue Date

01/30/2012

Effective Date

02/05/2016

Expiration Date

03/01/2018

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/10/2018